Basic Information
Provider Information
NPI: 1295178697
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: BRIAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 E MCBEE AVE FL 4
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296012842
CountryCode: US
TelephoneNumber: 8645228603
FaxNumber:  
Practice Location
Address1: 200 PATEWOOD DR STE C300
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296156324
CountryCode: US
TelephoneNumber: 8644548272
FaxNumber: 8644542875
Other Information
ProviderEnumerationDate: 04/16/2013
LastUpdateDate: 07/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X34061ALN Allopathic & Osteopathic PhysiciansSurgery 
2086S0129X34061ALN Allopathic & Osteopathic PhysiciansSurgeryVascular Surgery
2086S0129X61157SCY Allopathic & Osteopathic PhysiciansSurgeryVascular Surgery

No ID Information.


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