Provider Demographics
NPI:1144280439
Name:JONES, TYNDAL MICHELE (MD)
Entity type:Individual
Prefix:DR
First Name:TYNDAL
Middle Name:MICHELE
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 1:2775 CRUSE RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-7140
Mailing Address - Country:US
Mailing Address - Phone:678-380-1200
Mailing Address - Fax:678-380-7494
Practice Address - Street 1:2775 CRUSE RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-7140
Practice Address - Country:US
Practice Address - Phone:678-380-1200
Practice Address - Fax:678-380-7494
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044249207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000867578EMedicaid
GA000867578FMedicaid
GA000867578GMedicaid
GA000867578EMedicaid
H91325Medicare UPIN