MEDICARE: DR. DOUGLAS CHALLENOR JONES O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC2773	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063587327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS CHALLENOR JONES O.D.

Provider Business Mailing Address
First Line	:	928 FALLING WATER RD
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-3554
Country	:	US
Telephone Number	:	954-636-2230
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 PALM BEACH LAKES BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-2020
Country	:	US
Telephone Number	:	561-683-5710
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	07/08/2007

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