Jones, Gregory Donald
Jones, Gregory Donald is an sole proprietor health care provider with primary practice located at Walmart Vision Ctr #2274 200 Ksw 12Th St, Forest Lake MN 55025-1609. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jones, Gregory Donald can be contacted via phone (651) 464-9767.Contact Information
Primary practice address
Walmart Vision Ctr #2274 200 Ksw 12Th St
Forest Lake MN 55025-1609
Phone: (651) 464-9767
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1908 | Minnesota |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1876 | Wisconsin |
Profile Details
| NPI number | 1295829752 |
|---|---|
| LBN Legal business name | Jones, Gregory Donald |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295829752 | NPPES |
| Minnesota | Other | B19461046411 | MEDICAID |
| Minnesota | Other | 2202279 | MEDICAID |
| Minnesota | Other | 5C403JO | MEDICAID |
| Minnesota | Other | 2202278 THRU 2202296 | MEDICAID |
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