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NPI Code Detail

MEDICARE: BLAKE A JONES MD

MEDICARE: BLAKE A JONES MD
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
1207RG0100XGastroenterology Physician8918SD

Other Identifiers

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

General Provider Information

NPI Number : 1659370930
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLAKE A JONES MD
Provider Business Mailing Address
First Line : PO BOX 6020
Second Line :
City : RAPID CITY
State : SD
Zip : 57709-6020
Country : US
Telephone Number : 605-342-3280
Fax Number : 605-721-8435
Provider Business Practice Location Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5462
Country : US
Telephone Number : 605-342-3280
Fax Number : 605-721-8435
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 04/02/2025

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