Doctor Name: | DOUGLAS JONES |
NPI Number: | 1255548020 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 3051 Commerce Dr Ste. 5 Fort Gratiot, MI - 480593866 |
Business Phone Number: | 8103854463 |
Business Fax Number: | 8103858875 |
Mailing Address: | 3271 W Charmwood Dr, Apt. A PORT HURON |
State: | MI |
Postal Code: | 480601631 |
Phone Number: | 8109660870 |
Fax Number: | |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |