Provider Demographics
NPI:1114328432
Name:DR. MARCUS G JONES
Entity Type:Organization
Organization Name:DR. MARCUS G JONES
Other - Org Name:QUANTUM WELLNESS & CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELYEA
Authorized Official - Suffix:
Authorized Official - Credentials:CA
Authorized Official - Phone:605-275-5655
Mailing Address - Street 1:502 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-2450
Mailing Address - Country:US
Mailing Address - Phone:605-275-5655
Mailing Address - Fax:605-275-5658
Practice Address - Street 1:502 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-2450
Practice Address - Country:US
Practice Address - Phone:605-275-5655
Practice Address - Fax:605-275-5658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-05
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD965111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7602500Medicaid
SD7602500Medicaid