Individual
DR. BRADLEY D. JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
404 W ROLLA RD, SALEM, MO 65560-1233
(573) 729-6225
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
103590
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154360410
—
MO
01
—
431560263
TRICARE
MO
Enumeration date
06/05/2006
Last updated
10/02/2014
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