Provider Demographics
NPI:1801803770
Name:JONES, ROBERT ALAN (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:JONES
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1515 LAKE LANSING RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3753
Mailing Address - Country:US
Mailing Address - Phone:517-332-2233
Mailing Address - Fax:517-332-8035
Practice Address - Street 1:1515 LAKE LANSING RD
Practice Address - Street 2:SUITE G
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3753
Practice Address - Country:US
Practice Address - Phone:517-332-2233
Practice Address - Fax:517-332-8035
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4901003668152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI22-70059OtherPHPFC
MI22-00059OtherPHPMM
MIU52519Medicare UPIN
MI22-70059OtherPHPFC
MIOP10740002Medicare ID - Type UnspecifiedDR. ROBERT A. JONES