Individual
RICHARD THOMAS JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
32 W 1ST S, REXBURG, ID 83440-1810
(208) 356-7585
(208) 356-7566
Mailing address
32 W 1ST S, REXBURG, ID 83440-1810
(208) 356-7585
(208) 356-7566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
7553A
WY
207Q00000X
Family Medicine Physician
Primary
M-10078
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123432300
—
WY
05
—
807875400
—
ID
05
—
807909700
—
ID
Enumeration date
09/26/2006
Last updated
02/17/2009
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