Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 26963 | SC |
Y | 208600000X | Surgeon | 26963 | SC |
N | 2086S0102X | Surgical Critical Care | 26963 | SC |
N | 2086S0127X | Trauma Surgeon | 26963 | SC |
NPI | 1295863058 |
---|---|
Provider Name | Dr. Mark Allen Jones |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29203-6859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 16/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
269630 | (05) | SC |