Basic Information
| Provider Information | |||||||||
| NPI: | 1952629107 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARMAN EYE CENTER OF DANVILLE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1290 | ||||||||
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| City: | FOREST | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245511290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4343855600 | ||||||||
| FaxNumber: | 4344557172 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 EXECUTIVE DR | ||||||||
| Address2: | STE E | ||||||||
| City: | DANVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245414155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4347935500 | ||||||||
| FaxNumber: | 4344557172 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2010 | ||||||||
| LastUpdateDate: | 09/08/2015 | ||||||||
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| AuthorizedOfficialLastName: | BURTON | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
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| AuthorizedOfficialTitleorPosition: | INSURANCE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4343855600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | PENDING | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.