Individual
GORDON JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
461 S NOVA RD, ORMOND BEACH, FL 32174-6138
(386) 671-4337
Mailing address
461 S NOVA RD, ORMOND BEACH, FL 32174-6138
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME83420
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014815400
—
FL
01
—
1477513661
TRICARE
FL
01
—
62971
BCBS
FL
01
—
ME83420
VHN
FL
01
—
P00793197
RAILROAD
FL
Enumeration date
03/23/2006
Last updated
06/13/2023
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