Provider Demographics
NPI:1487858155
Name:DAVID I. JONES, O.D., P.C.
Entity Type:Organization
Organization Name:DAVID I. JONES, O.D., P.C.
Other - Org Name:ADVANCED FAMILY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:IVAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:801-423-6516
Mailing Address - Street 1:57 E 1000 N
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1200
Mailing Address - Country:US
Mailing Address - Phone:801-423-6516
Mailing Address - Fax:801-798-2707
Practice Address - Street 1:57 E 1000 N
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1200
Practice Address - Country:US
Practice Address - Phone:801-423-6516
Practice Address - Fax:801-798-2707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT362409-9934332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT522824847001Medicaid
UT522824847001Medicaid