Basic Information
| Provider Information | |||||||||
| NPI: | 1629050703 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARVAT | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | PAUL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2800 SW WANAMAKER RD | ||||||||
| Address2: | SUITE 192 | ||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666144293 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852720707 | ||||||||
| FaxNumber: | 7852711512 | ||||||||
| Practice Location | |||||||||
| Address1: | 2600 IOWA ST | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660464152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858426999 | ||||||||
| FaxNumber: | 7858421291 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2005 | ||||||||
| LastUpdateDate: | 06/24/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | KS-1596 | KS | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 650813 | 01 | BCBS | OTHER | 100403390B | 05 | KS | MEDICAID | P00108531 | 01 | KS | MEDICARE RAILROAD | OTHER | 650835 | 01 | KS | BCBS | OTHER | 650917 | 01 | KS | TRICARE | OTHER | 650917 | 01 | BCBS | OTHER |