Provider Demographics
NPI:1972514222
Name:JONES, JAMES V (O D)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:V
Last Name:JONES
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 MEMORIAL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-5112
Mailing Address - Country:US
Mailing Address - Phone:301-334-1016
Mailing Address - Fax:301-334-9729
Practice Address - Street 1:888 MEMORIAL DR STE 101
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-5112
Practice Address - Country:US
Practice Address - Phone:301-334-1016
Practice Address - Fax:301-334-9729
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00794152W00000X
WV712-OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD214828500Medicaid
MD239019ML2OtherMAMSI LIFE & HEALTH INS
WV0150787000Medicaid
MD239019MD2OtherMDIPA HEALTH PLAN
WV1017536OtherBRICKSTREET MUTUAL INSURA
MD2390190C2OtherOPTIMUM CHOICE
WV1017536OtherBRICKSTREET MUTUAL INSURA
MDX370Medicare PIN