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General NPI Number Information
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NPI Number | 1912145962
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Entity Type | Organization
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Legal Business Name | ROGER I JONES, O.D. LLC
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 411 PARK PLAZA DR
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City | OWENSBORO
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State | KY
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Zip | 42301-5449
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Country | US
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Telephone | 270-686-1937
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Fax | 270-686-0000
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Provider Business Mailing Address
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Address Line | 411 PARK PLAZA DR
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City | OWENSBORO
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State | KY
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Zip | 42301-5449
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Country | US
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Telephone | 270-686-1937
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Fax | 270-686-0000
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROGER I JONES
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Credential | O.D.
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Telephone | 270-686-1937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 953DT
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License Number State | KY
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