Provider Demographics
NPI:1366423303
Name:JONES, MARK WAYNE (DO)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:WAYNE
Last Name:JONES
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2720 S WASHINGTON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-2873
Mailing Address - Country:US
Mailing Address - Phone:517-487-8255
Mailing Address - Fax:517-487-2059
Practice Address - Street 1:2720 S WASHINGTON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-2873
Practice Address - Country:US
Practice Address - Phone:517-487-8255
Practice Address - Fax:517-487-2059
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2010-04-20
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Provider Licenses
StateLicense IDTaxonomies
MI5101010550208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1020399OtherMCLAREN
MI4908848Medicaid
MIP00397821OtherMEDICARE RAILROAD
MI0253311744OtherBCBSM
MI1020399OtherMCLAREN HEALTH PLAN
MI200000002185OtherPHYSICIANS HEALTH PLAN
MA305251OtherINGHAM HEALTH PLAN
MI0253311744OtherBLUE CROSS
MI1020399OtherMCLAREN
MI200000002185OtherPHYSICIANS HEALTH PLAN