MEDICARE: BRENDA FAYE JONES M.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	207W00000X	Ophthalmology Physician	55641	OH
2	207W00000X	Ophthalmology Physician	17844	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01296262	OTHER	OH	RAILROAD MEDICARE - MHCPI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588663645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA FAYE JONES M.D.

Provider Business Mailing Address
First Line	:	161 W 200 N STE 200
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84770-7386
Country	:	US
Telephone Number	:	435-986-2020
Fax Number	:	435-652-1516

Provider Business Practice Location Address
First Line	:	330 N SANDHILL BLVD STE A
Second Line	:
City	:	MESQUITE
State	:	NV
Zip	:	89027-4779
Country	:	US
Telephone Number	:	702-346-2950
Fax Number	:	702-346-3795

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	05/08/2018

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Directions to “ BRENDA FAYE JONES M.D.” Practice Location

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