Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 00012488 | AL |
NPI | 1134149255 |
---|---|
Provider Name | Martin Paul Jones JR. |
First Address | Birmingham, AL 35209-6862 |
Second Address | Birmingham, AL 35209-6862 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 29/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009910679 | (05) | AL |
051527179 | (05) | AL |
51541113 | BCBS (01) | AL |
E90165 | (02) | AL |