Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 31850 | KY |
Y | 207QA0401X | Family Doctor - Addiction Medicine | ME129389 | FL |
NPI | 1861423550 |
---|---|
Provider Name | Dr. Greg L Jones |
First Address | Gainesville, FL 32610-3001 |
Second Address | Gainesville, FL 32610-3001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 13/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
019121200 | (05) | FL |