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General NPI Number Information
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NPI Number | 1629096052
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Entity Type | Individual
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Provider Name | MATTHEW B JONES MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 08/04/2018
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Provider Practice Location Address
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Address Line | 1621 DALTON TER
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City | MANCHESTER
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State | MO
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Zip | 63021
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Country | US
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Telephone | 636-399-3073
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Fax |
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Provider Business Mailing Address
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Address Line | 1621 DALTON TER
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City | MANCHESTER
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State | MO
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Zip | 63021-7078
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Country | US
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Telephone | 636-399-3073
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | R9N80
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | R9N80
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 35.096959
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | R9N80
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License Number State | MO
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