Doctor Name: | MR. MATTHEW THOMAS JONES |
NPI Number: | 1659756542 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-C |
License Number: | AP7963 |
Business Practice Address: | 520 Rose Ln Wickenburg, AZ - 853901447 |
Business Phone Number: | 9286681845 |
Business Fax Number: | |
Mailing Address: | 519 Rose Ln, WICKENBURG |
State: | AZ |
Postal Code: | 853901448 |
Phone Number: | 9286681833 |
Fax Number: | 9286847457 |
NPI Enumeration Date: | 07/21/2015 |
NPI Last Update Date: | 07/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP7963 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |