Individual
DR. GARY MICHEAL JONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 SAINT FRANCIS AVE, SUITE 200, SHAKOPEE, MN 55379-3387
(952) 993-7819
Mailing address
8685 MAGNOLIA TRL APT 300, EDEN PRAIRIE, MN 55344-4610
(612) 437-1839
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101240163
VA
208600000X
Surgery Physician
Primary
45436
MN
208600000X
Surgery Physician
D0064985
MD
208600000X
Surgery Physician
MD036245
DC
Other
Enumeration date
08/30/2006
Last updated
12/11/2012
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