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General NPI Number Information
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NPI Number | 1295707099
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Entity Type | Individual
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Provider Name | JUDY LEE JONES MD
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Gender | Female
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 2001 S WOODRUFF SUITE 19
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City | IDAHO FALLS
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State | ID
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Zip | 83404
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Country | US
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Telephone | 208-529-2603
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Fax | 208-529-0451
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Provider Business Mailing Address
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Address Line | 2001 S WOODRUFF SUITE 19
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City | IDAHO FALLS
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State | ID
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Zip | 83404
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Country | US
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Telephone | 208-529-2603
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Fax | 208-529-0451
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M4671
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License Number State | ID
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