Doctor Name: | DR. GARY MOSHER JONES |
NPI Number: | 1407104482 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 007735 |
Business Practice Address: | 2004 Riding Ridge Rd Columbia, SC - 292236713 |
Business Phone Number: | 8037882302 |
Business Fax Number: | 8037882302 |
Mailing Address: | 2004 Riding Ridge Rd, COLUMBIA |
State: | SC |
Postal Code: | 292236713 |
Phone Number: | 8037882302 |
Fax Number: | 8037882302 |
NPI Enumeration Date: | 08/22/2012 |
NPI Last Update Date: | 08/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 007735 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |