Healthcare Provider Details

I. General information

NPI: 1235675711
Provider Name (Legal Business Name): LUKE JONES MB BS, FRCS(T&O)
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROADWAY ST DEPARTMENT OF ORTHOPAEDIC SURGERY
REDWOOD CITY CA
94063-3132
US

IV. Provider business mailing address

450 BROADWAY ST DEPARTMENT OF ORTHOPAEDIC SURGERY
REDWOOD CITY CA
94063-3132
US

V. Phone/Fax

Practice location:
  • Phone: 650-430-7361
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberF474
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: