Provider Demographics
NPI:1447386180
Name:ALLEN S JONES OD PC
Entity Type:Organization
Organization Name:ALLEN S JONES OD PC
Other - Org Name:SIBLEY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:712-324-5151
Mailing Address - Street 1:323 9TH ST
Mailing Address - Street 2:P.O. BOX 409
Mailing Address - City:SHELDON
Mailing Address - State:IA
Mailing Address - Zip Code:51201-1556
Mailing Address - Country:US
Mailing Address - Phone:712-324-5151
Mailing Address - Fax:712-324-5036
Practice Address - Street 1:228 9TH ST
Practice Address - Street 2:
Practice Address - City:SIBLEY
Practice Address - State:IA
Practice Address - Zip Code:51249-1801
Practice Address - Country:US
Practice Address - Phone:712-754-4621
Practice Address - Fax:712-754-2762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02226152W00000X, 332H00000X
IA01564152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0245630002Medicare NSC