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Individual

DR. JONATHAN SULLIVAN JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5582
Mailing address
3836 EASTOVER DR, JACKSON, MS 39211-6730
(601) 421-1033

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19318
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00430397
MS
01
512I930380
MEDICARE PTAN
MS
01
P00636222
MEDICARE RR#
MS
01
P01246637
RAILROAD MEDICARE
MS
Enumeration date
07/26/2006
Last updated
02/27/2018
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