Provider Demographics
NPI:1245256973
Name:JONES, STEVEN R (DPM)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:JONES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2361 MURRAY HOLLADAY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-4512
Mailing Address - Country:US
Mailing Address - Phone:801-277-8512
Mailing Address - Fax:801-277-8562
Practice Address - Street 1:2361 MURRAY HOLLADAY RD
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-4512
Practice Address - Country:US
Practice Address - Phone:801-277-8512
Practice Address - Fax:801-277-8562
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT103418-0501213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTT77937Medicare UPIN