Provider Demographics
NPI:1649440108
Name:RONALD C. JONES, M.D., P.C.
Entity type:Organization
Organization Name:RONALD C. JONES, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:CALVIN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-373-1275
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:OAK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84649-0219
Mailing Address - Country:US
Mailing Address - Phone:801-885-5622
Mailing Address - Fax:801-377-2779
Practice Address - Street 1:3325 N UNIVERSITY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-4465
Practice Address - Country:US
Practice Address - Phone:801-373-1275
Practice Address - Fax:801-377-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT170264-1205302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD20389Medicare UPIN