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Individual

JONATHAN M JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
114 W. 11TH STREET, HMS MED SQUARE CLINIC, SILVER CITY, NM 88061-5136
(575) 388-1511
(575) 542-8367
Mailing address
530 DEMOSS STREET, HIDALGO MEDICAL SERVICES, LORDSBURG, NM 88045-2618
(575) 542-8384
(575) 542-8367

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4615
AZ
208000000X
Pediatrics Physician
Primary
A-1692-12
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
53286758
NM
01
NMA1029998
MEDICARE PTAN
NM
Enumeration date
05/02/2007
Last updated
11/16/2012
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