Provider Demographics
NPI:1750455564
Name:JONES, DONALD CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:CHARLES
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DONALD
Other - Middle Name:CHARLES
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2600 SPRING ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3604
Mailing Address - Country:US
Mailing Address - Phone:517-788-6470
Mailing Address - Fax:517-788-5547
Practice Address - Street 1:2600 SPRING ARBOR RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3604
Practice Address - Country:US
Practice Address - Phone:517-788-6470
Practice Address - Fax:517-788-5547
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062371207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4167040Medicaid
MI104167040Medicaid
MI200000004383OtherPHPSM
MI900031018OtherPRIORITY HEALTH
MI080380035OtherBCBSM
MI080380035OtherBLUE CARE NETWORK