Provider Demographics
NPI:1881922078
Name:JONES, MATTHEW HOWARD (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:HOWARD
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 DERDALL DR
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-2851
Mailing Address - Country:US
Mailing Address - Phone:605-697-5145
Mailing Address - Fax:605-697-5135
Practice Address - Street 1:2218 DERDALL DR
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2851
Practice Address - Country:US
Practice Address - Phone:605-697-5145
Practice Address - Fax:605-697-5135
Is Sole Proprietor?:No
Enumeration Date:2009-11-26
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1158111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9284844OtherDAKOTACARE
SD9178925OtherDAKOTACARE
SDS7727Medicare PIN
SD1356510812Medicare PIN
SD9178925OtherDAKOTACARE