Provider Demographics
NPI:1033940911
Name:JONES, ALEXIS (CERTIFIED HAIR LOSS)
Entity type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CERTIFIED HAIR LOSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CLINTON CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032-5914
Mailing Address - Country:US
Mailing Address - Phone:478-456-4810
Mailing Address - Fax:
Practice Address - Street 1:4274 GRAY HWY STE F
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:GA
Practice Address - Zip Code:31032-5937
Practice Address - Country:US
Practice Address - Phone:478-456-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACO0882861744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management