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Individual

MICHAEL GARY JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
777 HOSPITAL WAY, BLDG A SUITE 300, POCATELLO, ID 83201-5176
(208) 232-6100
Mailing address
777 HOSPITAL WAY, BLDG A SUITE 300, POCATELLO, ID 83201-5176
(208) 232-6100

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
O0428
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
317455
ALTIUS
ID
05
807748300
ID
01
P00412313
RAILROAD MEDICARE
ID
Enumeration date
10/02/2006
Last updated
07/19/2012
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