MEDICARE: ROBERT W. JONES

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	R1J10	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	826183118	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	180080	OTHER		HEALTHLINK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	81888	OTHER	AR	AR BLUE CROSS BLUE SHIELD
5	10540	OTHER	MO	MO BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1356351241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT W. JONES

Provider Business Mailing Address
First Line	:	1405 DOCTORS DR
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-4754
Country	:	US
Telephone Number	:	417-256-4111
Fax Number	:	417-256-8939

Provider Business Practice Location Address
First Line	:	1405 DOCTORS DR
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-4754
Country	:	US
Telephone Number	:	417-256-4111
Fax Number	:	417-256-8939

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	BEN MARTIN
Credential	:
Telephone Number	:	417-256-4111

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	07/21/2023

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Directions to “ROBERT W. JONES ” Practice Location

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