| Jones Family Medical Clinic, Pllc | |
|
1200 N Gloster St Tupelo MS 38804-1206 | |
| (662) 840-0990 | |
| (662) 840-0182 |
| Full Name | Jones Family Medical Clinic, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1200 N Gloster St, Tupelo, Mississippi |
| Authorized Official Name and Position | Kathy M Allred (OFFICE MANAGER) |
| Authorized Official Contact | 6628400990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jones Family Medical Clinic, Pllc 1200 N Gloster St Tupelo MS 38804-1206 Ph: (662) 840-0990 | Jones Family Medical Clinic, Pllc 1200 N Gloster St Tupelo MS 38804-1206 Ph: (662) 840-0990 |
| NPI Number | 1346446705 |
|---|---|
| Provider Enumeration Date | 06/22/2007 |
| Last Update Date | 09/12/2014 |
| Medicare PECOS PAC ID | 8527182872 |
|---|---|
| Medicare Enrollment ID | O20100824000638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346446705 | NPI | - | NPPES |
| 1346446705 | Other | MS | NPI JONES FAMILY MEDICAL CLINIC, PLLC |
| 302G080670 | Other | MS | MEDICARE PTAN |
| 080002925 | Other | MS | MEDICARE PTAN PHIL JONES INDIVIDUAL |
| 00015920 | Other | MS | MEDICAID INDIVIDUAL PHIL JONES |
| 12788 | Other | MS | PHILLIP JONES, MD LISCENS |
| 1770636243 | Other | MS | NPI TAMMIE WATERS INDIVIDUAL |
| 425198301A | Other | MS | JONES BCBS |
| 001204741 | Other | MS | MEDICAID TAMMIE WATERS INDIVIDUAL |
| P01004732 | Other | RAILROAD MEDICARE TAMMIE WATERS IND | |
| 09015894 | Medicaid | MS | |
| DS1903 | Other | MS | RAILROAD MEDICARE GROUP |
| R574929 | Other | MS | LISCENSE TAMMIE WATERS |
| 080136332 | Other | MS | RAILROAD MEDICARE PTAN PHIL JONES |
| 1659399723 | Other | JONES NPI INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Phillip Edward Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659399723 PECOS PAC ID: 2062536311 Enrollment ID: I20100824000701 |
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