Provider Demographics
NPI:1891766572
Name:JONES, CHARLES FREDERICK (MD,)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:FREDERICK
Last Name:JONES
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2880 DAUPHIN ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-2457
Mailing Address - Country:US
Mailing Address - Phone:251-635-0919
Mailing Address - Fax:251-635-0924
Practice Address - Street 1:610 PROVIDENCE PARK DR E
Practice Address - Street 2:BLDG. 2, SUITE 202
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4622
Practice Address - Country:US
Practice Address - Phone:251-635-0919
Practice Address - Fax:251-635-0924
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00008808207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1201366OtherUNITED HEALTHCARE PROV #
AL4006611OtherAETNA PROVIDER #
AL51532641OtherBLUE CROSS PROVIDER #
ALC75191OtherHEALTHSPRING PROVIDER #
ALC75191OtherHEALTHSPRING PROVIDER #