Healthcare Provider Details

I. General information

NPI: 1639163405
Provider Name (Legal Business Name): DAVID EDWARD JONES DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAVID EDWARD JONES DPM

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3070 WELLNER DR NE
ROCHESTER MN
55906-8427
US

IV. Provider business mailing address

6625 LYNDALE AVE S STE 300
RICHFIELD MN
55423-2491
US

V. Phone/Fax

Practice location:
  • Phone: 612-655-7774
  • Fax: 507-218-3097
Mailing address:
  • Phone: 612-788-8778
  • Fax: 612-869-3473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number3327
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36002093
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number553
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number553
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: