Provider Demographics
NPI:1952305583
Name:JONES, THOMAS MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:MARTIN
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E BOYD AVE
Mailing Address - Street 2:STE 208
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-2818
Mailing Address - Country:US
Mailing Address - Phone:317-462-1992
Mailing Address - Fax:317-462-1999
Practice Address - Street 1:300 E BOYD AVE
Practice Address - Street 2:STE 208
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-2818
Practice Address - Country:US
Practice Address - Phone:317-462-1992
Practice Address - Fax:317-462-1999
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041972A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INF74728Medicare UPIN
IN321950CMedicare ID - Type Unspecified