Jones, Gregory Donald

Jones, Gregory Donald is an sole proprietor health care provider with primary practice located at Walmart Vision Ctr #2274 200 Ksw 12Th St, Forest Lake MN 55025-1609. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jones, Gregory Donald can be contacted via phone (651) 464-9767.

Contact Information

Primary practice address
Walmart Vision Ctr #2274 200 Ksw 12Th St Forest Lake MN 55025-1609
Phone: (651) 464-9767
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1908 Minnesota
Eye and Vision Services Providers / Optometrist 152W00000X 1876 Wisconsin

Profile Details

NPI number 1295829752
LBN Legal business name Jones, Gregory Donald
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295829752 NPPES
Minnesota Other B19461046411 MEDICAID
Minnesota Other 2202279 MEDICAID
Minnesota Other 5C403JO MEDICAID
Minnesota Other 2202278 THRU 2202296 MEDICAID

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