Samuel Riddle Jones, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Blountville, TN
NPI 1790079010 · NPPES record last updated Jun 3, 2011
Key facts
- NPI
- 1790079010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- M.D.4683 (TN)
- Practice address
- 594 Bill Moody Trail
Blountville, TN 37617 - Phone
- (423) 323-4237
- NPI assigned
- Jun 3, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M.D.4683 | TN | MD | Obstetrics & Gynecology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | M.D.4683 | TN | Yes |
Addresses
Primary practice location
594 Bill Moody Trail
Blountville, TN 37617
Mailing address
594 Bill Moody Trail
Blountville, TN 37617
Phone (423) 323-4237
Other providers in Blountville, TN
- Integralabs MDG Incorporated
- Ricky Lee Johnson Jr.
- Jones Adaptive Mobility LLC
- Everett Russell Jones Jr.
- Madison T Jones
- Theresa Midkiff Jordan
- Joyful Care Inc
- K VA T Food Stores Inc
- Erica Michelle Kegley
- Caroline E Kerns
All providers in Blountville, TN · Obstetrics & Gynecology Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.