Provider Demographics
NPI:1720179294
Name:JONES, BRUCE N (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:N
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:224 S WOODS MILL RD
Mailing Address - Street 2:SUITE 255S
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3491
Mailing Address - Country:US
Mailing Address - Phone:314-434-3240
Mailing Address - Fax:314-434-6956
Practice Address - Street 1:224 S WOODS MILL RD
Practice Address - Street 2:SUITE 255S
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3491
Practice Address - Country:US
Practice Address - Phone:314-434-3240
Practice Address - Fax:314-434-6956
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR9919207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO26440OtherBLUE CROSS BLUE SHIELD
MO4212657OtherAETNA
MO001011017Medicare ID - Type Unspecified
MOA13632Medicare UPIN