Provider Demographics
NPI:1972517662
Name:JONES, BART C (OD)
Entity type:Individual
Prefix:
First Name:BART
Middle Name:C
Last Name:JONES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PROFESSIONAL ACRES DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4340
Mailing Address - Country:US
Mailing Address - Phone:870-333-1087
Mailing Address - Fax:870-333-1088
Practice Address - Street 1:800 PROFESSIONAL ACRES DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4340
Practice Address - Country:US
Practice Address - Phone:870-333-1087
Practice Address - Fax:870-333-1088
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2503152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO315213900OtherMISSOURI MEDICAID
AR496517933OtherMEDICARE ID-TYPE UNSPECIFIED
AR410044503OtherRAILROAD MEDICARE
AR140596722Medicaid
ARU80938Medicare UPIN
AR49651Medicare PIN