MEDICARE: DEMETRIC JONES OD

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	S-F53-TA-D82	AL

General Provider Information

NPI Number	:	1194515312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEMETRIC JONES OD

Provider Business Mailing Address
First Line	:	4175 S. ALAMO AVE
Second Line	:
City	:	DAVIS MONTHAN AFB
State	:	AZ
Zip	:	85707-4405
Country	:	US
Telephone Number	:	520-228-2615
Fax Number	:

Provider Business Practice Location Address
First Line	:	4175 S. ALAMO AVE
Second Line	:
City	:	DAVIS MONTHAN AFB
State	:	AZ
Zip	:	85707-4405
Country	:	US
Telephone Number	:	520-228-2615
Fax Number	:

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

Provider Enumeration Date	:	05/09/2025
Last Update Date	:	08/29/2025

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Directions to “ DEMETRIC JONES OD” Practice Location

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