Provider Demographics
NPI:1801982665
Name:JONES, ERIC T (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:T
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 673671
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-3671
Mailing Address - Country:US
Mailing Address - Phone:313-745-5227
Mailing Address - Fax:313-745-5596
Practice Address - Street 1:3901 BEAUBIEN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2119
Practice Address - Country:US
Practice Address - Phone:313-745-5227
Practice Address - Fax:313-745-5596
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12237207X00000X
MI4301091329207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0099190000Medicaid
WVJO6011781Medicare ID - Type Unspecified
WV0099190000Medicaid
A72453Medicare UPIN