Provider Demographics
NPI:1386827244
Name:JONES, MATTHEW D (DPM)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:JONES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2698 E SCENIC OVERLOOK PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-8843
Mailing Address - Country:US
Mailing Address - Phone:520-979-1285
Mailing Address - Fax:
Practice Address - Street 1:5300 E ERICKSON DR
Practice Address - Street 2:SUITE 118
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2828
Practice Address - Country:US
Practice Address - Phone:520-326-6766
Practice Address - Fax:520-740-1939
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0666213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ440246Medicaid
AZZ131010Medicare PIN