Provider Demographics
NPI:1699707364
Name:JONES, GRAHAM P (MD)
Entity type:Individual
Prefix:DR
First Name:GRAHAM
Middle Name:P
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:500 GROVE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1761
Mailing Address - Country:US
Mailing Address - Phone:856-796-9200
Mailing Address - Fax:856-796-9397
Practice Address - Street 1:152 HIMMELIEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-9316
Practice Address - Country:US
Practice Address - Phone:609-654-7117
Practice Address - Fax:609-654-8555
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2014-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA01999600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3001008Medicaid
NJ3001008Medicaid
NJ027285C04Medicare PIN