Basic Information
Provider Information
NPI: 1720442668
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: CURRY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13623 NC 212 HWY
Address2:  
City: MARSHALL
State: NC
PostalCode: 287537670
CountryCode: US
TelephoneNumber: 8282060691
FaxNumber:  
Practice Location
Address1: 590 MEDICAL PARK DR
Address2:  
City: MARSHALL
State: NC
PostalCode: 287536807
CountryCode: US
TelephoneNumber: 8286493500
FaxNumber: 8286491032
Other Information
ProviderEnumerationDate: 04/06/2016
LastUpdateDate: 12/20/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/20/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X2019-02023NCY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
172044266805NC MEDICAID


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