Individual
MR. BRANDON DOUGLAS JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
875 LARRY NEIL WAY, KINGSPORT, TN 37660-6368
(423) 282-9011
Mailing address
2410 SUSANNAH ST, JOHNSON CITY, TN 37601-1748
(423) 282-9011
(423) 282-0035
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1467
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164593513
—
VA
05
—
1516342
—
TN
01
—
PA0001467
LICENSE
TN
Enumeration date
11/09/2006
Last updated
12/09/2019
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