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NPI Code Detail

MEDICARE: GREG JONES

MEDICARE: GREG JONES
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
13416S0300XWater AmbulanceIL

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 : 1750555470
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREG JONES
Provider Business Mailing Address
First Line : 3704 PONTOON RD
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-4240
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3704 PONTOON RD
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-4240
Country : US
Telephone Number : 618-931-3368
Fax Number :
Authorized Official
Title or Position : DMD PC
Name : GREG JONES
Credential :
Telephone Number : 618-931-3368
Provider Enumeration Date : 04/14/2008
Last Update Date : 04/14/2008

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