Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 3433 | SC |
Y | 213ER0200X | Radiology | 3433 | SC |
NPI | 1760624019 |
---|---|
Provider Name | Dr. David Ray Jones |
First Address | Easley, SC 29641-0853 |
Second Address | Easley, SC 29640-3038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 20/07/2012 |