Provider Demographics
NPI:1174727010
Name:JONES, TODD DWYER (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:DWYER
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 1205
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-0231
Mailing Address - Country:US
Mailing Address - Phone:253-770-9000
Mailing Address - Fax:253-770-9712
Practice Address - Street 1:104 27TH AVE SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-1145
Practice Address - Country:US
Practice Address - Phone:253-770-9000
Practice Address - Fax:253-770-9712
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301111482207Y00000X
WAMD60459916207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology