Provider Demographics
NPI:1598765810
Name:JONES, MICHAEL A (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
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 1:1000 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-2404
Mailing Address - Country:US
Mailing Address - Phone:937-492-1211
Mailing Address - Fax:937-492-6557
Practice Address - Street 1:1000 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-2404
Practice Address - Country:US
Practice Address - Phone:937-492-1211
Practice Address - Fax:937-492-6557
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10385213ES0103X
PASC005625213ES0103X
WV10385213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHVO5122Medicare UPIN
OHJO4158723Medicare PIN