Individual
DR. TERESA WIESE JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1110 YANKEE DOODLE RD, EAGAN, MN 55121-2092
(651) 454-3970
(651) 241-0059
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
55930
MN
207Q00000X
Family Medicine Physician
Primary
MD2019-0076
NM
Other
Enumeration date
04/27/2011
Last updated
02/18/2019
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