Provider Demographics
NPI:1588789853
Name:JONES, CORRON JERMELL (DC)
Entity type:Individual
Prefix:DR
First Name:CORRON
Middle Name:JERMELL
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 FERN CT
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-2111
Mailing Address - Country:US
Mailing Address - Phone:404-313-5336
Mailing Address - Fax:
Practice Address - Street 1:923 DILL AVE SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-4145
Practice Address - Country:US
Practice Address - Phone:404-753-3141
Practice Address - Fax:404-756-1092
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007983111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation