Provider Demographics
NPI:1619106952
Name:JONES, VALERIE LYN (OD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYN
Last Name:JONES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:LYN
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47872-0278
Mailing Address - Country:US
Mailing Address - Phone:765-569-2008
Mailing Address - Fax:765-569-2009
Practice Address - Street 1:725 N. LINCOLN RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47872
Practice Address - Country:US
Practice Address - Phone:765-569-2008
Practice Address - Fax:765-569-2009
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003583A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INAO2024OtherEYEMED
IN200954600Medicaid
IN65313OtherDAVIS VISION
INP00808449OtherRAILROAD MEDICARE
IN000000626213OtherANTHEM PIN
IN000000626213OtherANTHEM PIN