Provider Demographics
NPI:1942297338
Name:JONES, JUSTIN (OD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3271 E QUEEN CREEK RD
Mailing Address - Street 2:STE 107
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-8508
Mailing Address - Country:US
Mailing Address - Phone:480-892-3937
Mailing Address - Fax:480-892-3939
Practice Address - Street 1:3271 E QUEEN CREEK RD
Practice Address - Street 2:STE 107
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-8508
Practice Address - Country:US
Practice Address - Phone:480-892-3937
Practice Address - Fax:480-892-3939
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1448152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ128828Medicare PIN
V06544Medicare UPIN