Provider Demographics
NPI:1598226425
Name:JONES, GREG S (NMD)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:S
Last Name:JONES
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3728 E MONTEROSA ST APT 5
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-4846
Mailing Address - Country:US
Mailing Address - Phone:619-708-7975
Mailing Address - Fax:
Practice Address - Street 1:4425 N 24TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-5513
Practice Address - Country:US
Practice Address - Phone:602-614-9905
Practice Address - Fax:480-546-3401
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19-774175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath