Provider Demographics
NPI:1578657680
Name:JONES, MICHAEL LEE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEE
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1496 W HOOSIER BLVD
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IN
Mailing Address - Zip Code:46970-3727
Mailing Address - Country:US
Mailing Address - Phone:765-517-1078
Mailing Address - Fax:765-472-8999
Practice Address - Street 1:1496 W HOOSIER BLVD
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-3727
Practice Address - Country:US
Practice Address - Phone:765-517-1078
Practice Address - Fax:765-472-8999
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2024-09-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01053524A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine