Provider Demographics
NPI:1184831687
Name:EVAN D JONES, MD, PA
Entity Type:Organization
Organization Name:EVAN D JONES, MD, PA
Other - Org Name:CAROLINA EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTS PAYABLE
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-552-8220
Mailing Address - Street 1:3325 ASHLEY PHOSPHATE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-8467
Mailing Address - Country:US
Mailing Address - Phone:843-552-8220
Mailing Address - Fax:
Practice Address - Street 1:3325 ASHLEY PHOSPHATE RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-8467
Practice Address - Country:US
Practice Address - Phone:843-552-8220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6656207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC2154Medicaid
SCC60215Medicare UPIN
SCPC2154Medicaid