Provider Demographics
NPI:1437429313
Name:JONES, OTTIWELL WOOD III (MD)
Entity Type:Individual
Prefix:DR
First Name:OTTIWELL
Middle Name:WOOD
Last Name:JONES
Suffix:III
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 1:202 E HIGH DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2811
Mailing Address - Country:US
Mailing Address - Phone:509-747-1377
Mailing Address - Fax:
Practice Address - Street 1:202 E HIGH DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2811
Practice Address - Country:US
Practice Address - Phone:509-747-1377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00008617207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD00008617OtherMEDICAL LICENSE