Provider Demographics
NPI:1861721730
Name:TASHA J. JONES, O.D. P.C
Entity type:Organization
Organization Name:TASHA J. JONES, O.D. P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:605-692-2020
Mailing Address - Street 1:1100 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-2206
Mailing Address - Country:US
Mailing Address - Phone:605-692-2020
Mailing Address - Fax:605-692-9594
Practice Address - Street 1:1208 22ND AVE S
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2804
Practice Address - Country:US
Practice Address - Phone:605-692-2020
Practice Address - Fax:605-692-9594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD603152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD603OtherDAKOTACARE
SD4995289OtherBCBS OF SD
SD603OtherDAKOTACARE
SDS103906Medicare PIN