Provider Demographics
NPI:1942310362
Name:JONES, ALLEN S (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:S
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 1:323 9TH ST
Mailing Address - Street 2:P.O. BOX 409
Mailing Address - City:SHELDON
Mailing Address - State:IA
Mailing Address - Zip Code:51201-1556
Mailing Address - Country:US
Mailing Address - Phone:712-324-5151
Mailing Address - Fax:712-324-5036
Practice Address - Street 1:323 9TH ST
Practice Address - Street 2:
Practice Address - City:SHELDON
Practice Address - State:IA
Practice Address - Zip Code:51201-1556
Practice Address - Country:US
Practice Address - Phone:712-324-5151
Practice Address - Fax:712-324-5036
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01564152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1091751Medicaid
IA0091751Medicaid
IAT00687Medicare UPIN
IA1091751Medicaid