Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 246776 | MA |
N | 111NI0900X | Internist | 246776 | MA |
Y | 207RC0200X | Critical Care Medicine | 14416 | ND |
N | 207RC0200X | Critical Care Medicine | 48691 | TN |
NPI | 1043430010 |
---|---|
Provider Name | Dr. Adisa Jamil Jones |
First Address | Fargo, ND 58122-2484 |
Second Address | Fargo, ND 58102-3641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 17/03/2018 |