Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD18524 | TN |
N | 111NI0900X | Internist | MD18524 | TN |
N | 207RA0401X | Internist - Addiction Medicine | MD18524 | TN |
NPI | 1003998329 |
---|---|
Provider Name | Douglas Edgar Jones |
First Address | Memphis, TN 38119 |
Second Address | Memphis, TN 38119-5213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 16/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3031241 | (05) | TN |
A99497 | (02) |