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1437144078

NPI Code Detail

MEDICARE: WILBERT JONES M.D.

MEDICARE: WILBERT JONES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	30521	AZ
2	207R00000X	Internal Medicine Physician	MD27150	OR
3	208M00000X	Hospitalist Physician	MD27150	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01458321	OTHER	OR	RR MEDICARE (PH&S)-PMG

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437144078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILBERT JONES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3158
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-3158
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9205 SW BARNES RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97225-6603
Country	:	US
Telephone Number	:	503-216-2906
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/22/2021

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Directions to “ WILBERT JONES M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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