Provider Demographics
NPI:1528121779
Name:JONES, ALICIA TABISH (MD)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:TABISH
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9600 S 1300 E STE 230
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-3766
Mailing Address - Country:US
Mailing Address - Phone:801-571-7777
Mailing Address - Fax:801-523-1848
Practice Address - Street 1:9600 S 1300 E
Practice Address - Street 2:SUITE 300
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3766
Practice Address - Country:US
Practice Address - Phone:801-571-7777
Practice Address - Fax:801-523-1848
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7641755-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology