Provider Demographics
NPI:1649644519
Name:CARLA L. JONES O.D
Entity type:Organization
Organization Name:CARLA L. JONES O.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EYE DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:931-645-5851
Mailing Address - Street 1:1680 FORT CAMPBELL BLVD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-3537
Mailing Address - Country:US
Mailing Address - Phone:931-645-5851
Mailing Address - Fax:931-645-6917
Practice Address - Street 1:1680 FORT CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-3537
Practice Address - Country:US
Practice Address - Phone:931-645-5851
Practice Address - Fax:931-645-6917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1681152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1770626947Medicare PIN