Provider Demographics
NPI:1023535523
Name:CROWN POINT EYE CARE
Entity Type:Organization
Organization Name:CROWN POINT EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JOVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAVANJA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:219-789-9775
Mailing Address - Street 1:446 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-2390
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10823 BROADWAY
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7303
Practice Address - Country:US
Practice Address - Phone:219-310-8032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty