Provider Demographics
NPI:1033199492
Name:HARPER, JOE JOHN (OD)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:JOHN
Last Name:HARPER
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 1:479 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-2040
Mailing Address - Country:US
Mailing Address - Phone:731-635-1369
Mailing Address - Fax:731-635-0073
Practice Address - Street 1:479 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-2040
Practice Address - Country:US
Practice Address - Phone:731-635-1369
Practice Address - Fax:731-635-0073
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD0000000645152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNT61168Medicare UPIN
TN3594021Medicare PIN
TN0186590001Medicare NSC