Basic Information
| Provider Information | |||||||||
| NPI: | 1336433119 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | JEFFERSON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5080 PEACHTREE BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CHAMBLEE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303412877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047855437 | ||||||||
| FaxNumber: | 4047858053 | ||||||||
| Practice Location | |||||||||
| Address1: | 5080 PEACHTREE BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CHAMBLEE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303412877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047855437 | ||||||||
| FaxNumber: | 4047858053 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2011 | ||||||||
| LastUpdateDate: | 06/06/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 80232 | GA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.