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General NPI Number Information
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NPI Number | 1720213598
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Entity Type | Individual
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Provider Name | JACOB JONES D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 2905 W WARNER RD STE 12
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City | CHANDLER
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State | AZ
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Zip | 85224-1674
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Country | US
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Telephone | 480-831-8457
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 702-579-3203
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0736
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 0736
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License Number State | AZ
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