Provider Demographics
NPI:1760567317
Name:JONES, JOHN W
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:W
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 E LITTLE CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-4222
Mailing Address - Country:US
Mailing Address - Phone:757-588-0020
Mailing Address - Fax:
Practice Address - Street 1:1881 E LITTLE CREEK ROAD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-4222
Practice Address - Country:US
Practice Address - Phone:757-588-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0394156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician