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NPI Code Detail

MEDICARE: DR. MATTHEW ROBERT JONES OD

MEDICARE:  DR. MATTHEW ROBERT JONES  OD
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
1152W00000XOptometrist046010064IL

General Provider Information

NPI Number : 1578727368
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW ROBERT JONES OD
Provider Business Mailing Address
First Line : 118 W WASHINGTON AVE
Second Line :
City : EFFINGHAM
State : IL
Zip : 62401-2354
Country : US
Telephone Number : 217-342-2672
Fax Number : 217-342-2681
Provider Business Practice Location Address
First Line : 118 W WASHINGTON AVE
Second Line :
City : EFFINGHAM
State : IL
Zip : 62401-2354
Country : US
Telephone Number : 217-342-2672
Fax Number : 217-342-2681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2008
Last Update Date : 07/14/2008

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Directions to “ DR. MATTHEW ROBERT JONES OD” Practice Location

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