Basic Information
| Provider Information | |||||||||
| NPI: | 1679079263 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GROSS | ||||||||
| OtherFirstName: | DANA | ||||||||
| OtherMiddleName: | M | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 13623 NC HWY 212 | ||||||||
| Address2: | |||||||||
| City: | MARSHALL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062120459 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | HOT SPRINGS HEALTH PROGRAM, INC. | ||||||||
| Address2: | 590 MEDICAL PARK DRIVE | ||||||||
| City: | MARSHALL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286499566 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2018 | ||||||||
| LastUpdateDate: | 03/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 2020-12314 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.