Provider Demographics
NPI:1023844727
Name:JONES, TRISTAN COYT
Entity type:Individual
Prefix:
First Name:TRISTAN
Middle Name:COYT
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16145 HIGHWAY 159
Mailing Address - Street 2:
Mailing Address - City:KENNEDY
Mailing Address - State:AL
Mailing Address - Zip Code:35574-5107
Mailing Address - Country:US
Mailing Address - Phone:205-712-3397
Mailing Address - Fax:
Practice Address - Street 1:615 MCCALLIE AVE DEPT 1051
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2504
Practice Address - Country:US
Practice Address - Phone:423-425-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program