Provider Demographics
NPI:1922413699
Name:JONES, BRIAN DENNIS (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DENNIS
Last Name:JONES
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 CHANNING WAY STE 213
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-7541
Mailing Address - Country:US
Mailing Address - Phone:208-227-2575
Mailing Address - Fax:208-227-2571
Practice Address - Street 1:3100 CHANNING WAY
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7533
Practice Address - Country:US
Practice Address - Phone:208-227-2575
Practice Address - Fax:208-227-2571
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-21
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDO-1107207Q00000X
DCMTL002577390200000X
IDO1107208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program