Individual
MR. KENNETH PHYLEX JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3870 LEEDS AVENUE, SUITE 114, NORTH CHARLESTON, SC 29405-7493
(843) 207-7130
(843) 212-3674
Mailing address
PO BOX 62945, NORTH CHARLESTON, SC 29419-2945
(843) 207-7130
(843) 212-3674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
116298
SC
207Q00000X
Family Medicine Physician
Primary
SCMD11629
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11629
—
SC
Enumeration date
10/24/2006
Last updated
05/27/2015
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