Healthcare Provider Details

I. General information

NPI: 1881738128
Provider Name (Legal Business Name): ROBERT CLAIR JONES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 01/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 SOQUEL AVE
SANTA CRUZ CA
95062-2309
US

IV. Provider business mailing address

515 SOQUEL AVE
SANTA CRUZ CA
95062-2309
US

V. Phone/Fax

Practice location:
  • Phone: 831-426-2550
  • Fax: 831-426-5143
Mailing address:
  • Phone: 831-426-2550
  • Fax: 831-426-5143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA20300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: