Provider Demographics
NPI:1013004969
Name:JONES, FREDERICK W (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:W
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5010
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-5010
Mailing Address - Country:US
Mailing Address - Phone:701-418-8000
Mailing Address - Fax:701-857-5031
Practice Address - Street 1:400 BURDICK EXPY E
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4768
Practice Address - Country:US
Practice Address - Phone:701-857-7380
Practice Address - Fax:701-857-7342
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND9786208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13128Medicaid
ND24654Medicare ID - Type Unspecified
ND13128Medicaid