Provider Demographics
NPI:1164465647
Name:JONES, ROBERT G (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6360 S 3000 E
Mailing Address - Street 2:#220
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-6923
Mailing Address - Country:US
Mailing Address - Phone:801-944-3189
Mailing Address - Fax:801-944-3180
Practice Address - Street 1:6360 S 3000 E
Practice Address - Street 2:#310
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-6923
Practice Address - Country:US
Practice Address - Phone:801-944-3189
Practice Address - Fax:801-944-3180
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT4985419-1205207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTI53021Medicare UPIN
UT000059009Medicare PIN