Individual
JACK D JONES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PORTLAND ST STE 110, COLUMBIA, MO 65201-7390
(573) 886-4600
(573) 886-4695
Mailing address
300 PORTLAND ST STE 110, COLUMBIA, MO 65201-7390
(573) 886-4600
(573) 886-4695
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2006029248
MO
291U00000X
Clinical Medical Laboratory
2006029248
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109840003
—
MO
Enumeration date
07/27/2006
Last updated
04/20/2022
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