Provider Demographics
NPI:1750796223
Name:JONES, JEREMIAH MARTIN (MD)
Entity type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:MARTIN
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 1:1415 WOODLAND AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-3203
Mailing Address - Country:US
Mailing Address - Phone:515-241-4076
Mailing Address - Fax:515-241-4080
Practice Address - Street 1:1415 WOODLAND AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3203
Practice Address - Country:US
Practice Address - Phone:515-241-4076
Practice Address - Fax:515-241-4080
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-10084390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program