Individual
DR. RYAN TIMOTHY JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3000 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 321-7546
(269) 321-1705
Mailing address
3000 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 321-7546
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
5101021659
MI
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
5101021659
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225411705
—
MI
Enumeration date
07/02/2015
Last updated
09/16/2020
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