1659378396 NPI number — JARA BEST JONES M.D.

Table of content: JARA BEST JONES M.D. (NPI 1659378396)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659378396 NPI number — JARA BEST JONES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
JARA
Provider Middle Name:
BEST
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BEST
Provider Other First Name:
JARA
Provider Other Middle Name:
LAVONDA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659378396
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
51 NORTH DUNLAP STREET
Provider Second Line Business Mailing Address:
SUITE 410
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-523-2945
Provider Business Mailing Address Fax Number:
901-531-6381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1458 W POPLAR AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
COLLIERVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38017-0630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-457-2880
Provider Business Practice Location Address Fax Number:
901-457-2881
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  39011 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5440468 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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