Provider Demographics
NPI:1003080656
Name:HARVEY, ANDREW MORGAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MORGAN
Last Name:HARVEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12406 LA GRANGE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-1904
Mailing Address - Country:US
Mailing Address - Phone:502-243-3733
Mailing Address - Fax:502-243-3734
Practice Address - Street 1:12406 LA GRANGE RD STE 202
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-1904
Practice Address - Country:US
Practice Address - Phone:502-243-3733
Practice Address - Fax:502-243-3734
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1702DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100100120OtherGROUP MEDICAID
KY1790018034OtherGROUP NPI
KYP00920357OtherRR MEDICARE
KY1003080656OtherNPI
KY7100041380Medicaid