Provider Demographics
NPI:1982684411
Name:JONES, DAVID B (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:B
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 1:515 W BERTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:KS
Mailing Address - Zip Code:66536-1618
Mailing Address - Country:US
Mailing Address - Phone:785-437-2629
Mailing Address - Fax:
Practice Address - Street 1:515 W BERTRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:KS
Practice Address - Zip Code:66536-1618
Practice Address - Country:US
Practice Address - Phone:785-437-2105
Practice Address - Fax:785-437-2104
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0421765207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100110130BMedicaid
KSB69318Medicare UPIN