Provider Demographics
NPI:1902803224
Name:JONES, ZAUNDRA E (MD)
Entity Type:Individual
Prefix:
First Name:ZAUNDRA
Middle Name:E
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 OLEANDER DR
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5741
Mailing Address - Country:US
Mailing Address - Phone:843-449-9559
Mailing Address - Fax:843-497-6601
Practice Address - Street 1:4591 SOCASTEE BLVD
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-7209
Practice Address - Country:US
Practice Address - Phone:843-497-5929
Practice Address - Fax:843-293-1115
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27526207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC275268Medicaid
SC275268Medicaid
SCAA07284639Medicare PIN