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General NPI Number Information
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NPI Number | 1265622633
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Entity Type | Organization
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Legal Business Name | JONES VISION ASSOCIATES
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 2900 CUMBERLAND MALL SE
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City | ATLANTA
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State | GA
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Zip | 30339-8107
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Country | US
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Telephone | 770-431-1713
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Fax |
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Provider Business Mailing Address
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Address Line | 4495 REDAN CT
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City | SMYRNA
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State | GA
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Zip | 30080-9318
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Country | US
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Telephone | 770-431-1713
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Fax | 770-719-4392
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH ALLEN JONES
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Credential | OD
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Telephone | 770-431-1713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT002048
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License Number State | GA
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