Provider Demographics
NPI:1841401916
Name:JONES, JOSHUA LEWIS (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:LEWIS
Last Name:JONES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3550 N UNIVERSITY AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-6695
Mailing Address - Country:US
Mailing Address - Phone:801-374-9625
Mailing Address - Fax:801-374-9690
Practice Address - Street 1:1248 E 90 N STE 102
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2954
Practice Address - Country:US
Practice Address - Phone:801-756-9132
Practice Address - Fax:801-756-5091
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016220208600000X
CA20A11588208600000X
UT287566-1204208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGA942ZMedicare PIN