Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 014656 | LA |
NPI | 1164403382 |
---|---|
Provider Name | Dr. Gary P Jones |
First Address | Alexandria, LA 71301-4703 |
Second Address | Alexandria, LA 71301-3900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1349658 | (05) | LA |
D87089 | (02) | LA |