Basic Information
| Provider Information | |||||||||
| NPI: | 1831639764 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | CHRISTIAN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3239 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295023239 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 E CHEVES ST STE 260 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295062652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436657941 | ||||||||
| FaxNumber: | 8436651257 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2017 | ||||||||
| LastUpdateDate: | 09/13/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | LL52010 | SC | Y | Allopathic & Osteopathic Physicians | Surgery | 390200000X | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.