Individual
ETHAN ROBERT JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
Mailing address
335 LONG BOW CT, VALPARAISO, IN 46383-8308
(219) 286-0054
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/31/2024
Last updated
10/31/2024
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