Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD181303 | OR |
NPI | 1003868720 |
---|---|
Provider Name | Jonathan David Jones |
First Address | Corvallis, OR 97339-1189 |
Second Address | Corvallis, OR 97330-3785 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
807226900 | (05) | ID |
I38169 | (02) |