Individual
JOHN JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2740 NAVARRE AVE, OREGON, OH 43616
(419) 693-4444
(419) 693-4915
Mailing address
PO BOX 549, WABASH, IN 46992-0549
(260) 569-9550
(260) 569-0760
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18003853
IN
152W00000X
Optometrist
Primary
6527
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0211303
—
OH
05
—
201230990
—
IN
Enumeration date
06/23/2014
Last updated
08/15/2018
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