Healthcare Provider Details

I. General information

NPI: 1053979492
Provider Name (Legal Business Name): ERIC L JONES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2019
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 SUNRISE DR
SPRING GREEN WI
53588-9286
US

IV. Provider business mailing address

PO BOX 70
PRAIRIE DU SAC WI
53578-0070
US

V. Phone/Fax

Practice location:
  • Phone: 608-588-2600
  • Fax: 608-588-2502
Mailing address:
  • Phone: 608-643-3311
  • Fax: 608-643-7147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number81658-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: