Provider Demographics
NPI:1891872537
Name:JONES, ED ALVIN (OD)
Entity Type:Individual
Prefix:MR
First Name:ED
Middle Name:ALVIN
Last Name:JONES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 S SANTA FE AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-8004
Mailing Address - Country:US
Mailing Address - Phone:405-634-3535
Mailing Address - Fax:405-634-3535
Practice Address - Street 1:7500 S SANTA FE AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-8004
Practice Address - Country:US
Practice Address - Phone:405-634-3535
Practice Address - Fax:405-634-3535
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2016152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU17162Medicare UPIN
OK$$$$$$$$$Medicare PIN