Provider Demographics
NPI:1770661183
Name:JONES, AVERY THOMAS (OD)
Entity type:Individual
Prefix:DR
First Name:AVERY
Middle Name:THOMAS
Last Name:JONES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2200 SO WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201
Mailing Address - Country:US
Mailing Address - Phone:701-775-3135
Mailing Address - Fax:701-772-8161
Practice Address - Street 1:2200 SO WASHINGTON ST
Practice Address - Street 2:VALLEY VISION CLINIC
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201
Practice Address - Country:US
Practice Address - Phone:701-775-3135
Practice Address - Fax:701-772-8161
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2757152W00000X
ND412152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
60081OtherND DEPT OF HUMAN
410001573OtherMEDICARE RAILROAD UNITED
60327OtherVOCATIONAL REHAB CENTER
ND60327Medicaid
JON8828OtherBLUE SHIELD OF ND VISION
85536JOOtherBCBS MN
85536JOOtherMN COMPREHENSIVE CARE
JON800412OtherVISION SERVICES INC
JON8828OtherBLUE SHIELD OF ND ALTRU
140691OtherU CARE MN
2201969OtherMEDICA
MN670825100Medicaid
85536JOOtherBLUE PLUS OF MN
JON8828OtherBCBS ND
670825100OtherMN DEPT OF HUMAN
60081OtherND DEPT OF HUMAN
T90045Medicare UPIN
ND0174070001Medicare NSC
MN670825100Medicaid