Healthcare Provider Details

I. General information

NPI: 1568599827
Provider Name (Legal Business Name): ALLEN S JONES OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 9TH ST
SHELDON IA
51201-1556
US

IV. Provider business mailing address

PO BOX 409
SHELDON IA
51201-0409
US

V. Phone/Fax

Practice location:
  • Phone: 712-324-5151
  • Fax: 712-324-5036
Mailing address:
  • Phone: 712-324-5151
  • Fax: 712-324-5036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number01564
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number02226
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number01564
License Number StateIA

VIII. Authorized Official

Name: DR. ALLEN S JONES
Title or Position: PRESIDENT
Credential: O.D.
Phone: 712-324-5151