Provider Demographics
NPI:1902849888
Name:JONES, JOHN F JR (OD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:JONES
Suffix:JR
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 1:642 FRIENDLY CENTER RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7804
Mailing Address - Country:US
Mailing Address - Phone:336-292-7700
Mailing Address - Fax:
Practice Address - Street 1:642 FRIENDLY CENTER RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7804
Practice Address - Country:US
Practice Address - Phone:336-292-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1459152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2473341Medicare ID - Type Unspecified
U46966Medicare UPIN