Provider Demographics
NPI:1164589164
Name:JONES, MICHAEL PAUL (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PAUL
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 PERIMETER PARK DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-0910
Mailing Address - Country:US
Mailing Address - Phone:931-528-1304
Mailing Address - Fax:931-372-8958
Practice Address - Street 1:1125 PERIMETER PARK DR
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-0910
Practice Address - Country:US
Practice Address - Phone:931-528-1304
Practice Address - Fax:931-372-8958
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN69897207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1376586685OtherNPI GROUP
MO2011019383OtherMO LICENSE
IL036117802Medicaid
IL554490Medicare PIN
ILK38645Medicare PIN
IL036117802Medicaid
ILCF8691Medicare PIN
MO2011019383OtherMO LICENSE
IL554480Medicare PIN
ILCH6508Medicare PIN