MEDICARE: BRUCE 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
1	207Q00000X	Family Medicine Physician	036061729	IL

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

General Provider Information

NPI Number	:	1902869548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE JONES MD

Provider Business Mailing Address
First Line	:	3635 14TH AVE
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-3069
Country	:	US
Telephone Number	:	309-788-6244
Fax Number	:	309-788-6268

Provider Business Practice Location Address
First Line	:	3635 14TH AVE
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-3069
Country	:	US
Telephone Number	:	309-788-6244
Fax Number	:	309-788-6268

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

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	09/18/2013

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