Provider Demographics
NPI:1649217951
Name:JONES, DONALD R III (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:JONES
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2600 KANELL BLVD # 1
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-3001
Mailing Address - Country:US
Mailing Address - Phone:573-785-0313
Mailing Address - Fax:573-727-0079
Practice Address - Street 1:2600 KANELL BLVD # 1
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-3001
Practice Address - Country:US
Practice Address - Phone:573-785-0313
Practice Address - Fax:573-727-0079
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000146677207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204888101Medicaid
MO001013944Medicare PIN
MO160053778Medicare PIN
MOH12165Medicare UPIN