MEDICARE: JONES OAKLAND VISION GROUP P A

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	332H00000X	Eyewear Supplier	00794	MD
2	152W00000X	Optometrist	00794	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DT3340	OTHER	MD	PALMETTO RR MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	239019	OTHER	MD	OPTIMUM CHOICE
3	N9320001	OTHER	MD	BCBS PROVIDER #
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700061173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONES OAKLAND VISION GROUP P A

Provider Business Mailing Address
First Line	:	888 MEMORIAL DR STE 101
Second Line	:
City	:	OAKLAND
State	:	MD
Zip	:	21550-5112
Country	:	US
Telephone Number	:	301-334-1016
Fax Number	:	301-334-9729

Provider Business Practice Location Address
First Line	:	888 MEMORIAL DR STE 101
Second Line	:
City	:	OAKLAND
State	:	MD
Zip	:	21550-5112
Country	:	US
Telephone Number	:	301-334-1016
Fax Number	:	301-334-9729

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES V JONES
Credential	:	OD
Telephone Number	:	301-334-1016

Provider Enumeration Date	:	01/04/2008
Last Update Date	:	05/01/2023

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