Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2016-00758 | NC |
N | 111NI0900X | Internist | 2016-00758 | NC |
Y | 207RG0100X | Gastroenterologist | 2016-00758 | NC |
N | 207RG0100X | Gastroenterologist | 65035 | CT |
NPI | 1013355528 |
---|---|
Provider Name | Dr. Jason Deforest Jones |
First Address | Winston Salem, NC 27103-4014 |
Second Address | Winston Salem, NC 27103-4014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2013 |
Last Update Date | 25/06/2021 |