Provider Demographics
NPI:1629112867
Name:JONES, DONALD PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:PHILIP
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 RUSSELL HILL RD.
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ON
Mailing Address - Zip Code:M4V2T3
Mailing Address - Country:CA
Mailing Address - Phone:416-817-1975
Mailing Address - Fax:905-813-4024
Practice Address - Street 1:9501 LILE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6225
Practice Address - Country:US
Practice Address - Phone:501-954-8500
Practice Address - Fax:501-954-8502
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07303000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ051225DHKMedicare ID - Type Unspecified
NJH48945Medicare UPIN