1790718955 NPI number — DANIEL H. JONES, O.D., P.C.

Table of content: (NPI 1790718955)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790718955 NPI number — DANIEL H. JONES, O.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL H. JONES, O.D., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790718955
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
306 E 2ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWSON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64062-9347
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
660-707-1948
Provider Business Mailing Address Fax Number:
660-707-1969

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 GRAVES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHILLICOTHEE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64601-3071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-707-1948
Provider Business Practice Location Address Fax Number:
660-707-1969
Provider Enumeration Date:
07/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
H.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
816-813-6815

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  TO2812 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 15291059 . This is a "BCBSKC PROVIDER NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 50651 . This is a "DAVIS VISION PROVIDER #" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 540135 . This is a "NVA PROVIDER NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 34753 . This is a "AVESIS PROVIDER NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 25309 . This is a "SPECTERA PROVIDER NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 926700 . This is a "BLOCK PROVIDER NUMBER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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