Provider Demographics
NPI:1164426839
Name:HARVEY, TONI COATES (OD)
Entity Type:Individual
Prefix:DR
First Name:TONI
Middle Name:COATES
Last Name:HARVEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2148 N MALL DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3647
Mailing Address - Country:US
Mailing Address - Phone:318-442-0243
Mailing Address - Fax:318-442-2406
Practice Address - Street 1:2148 N MALL DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3647
Practice Address - Country:US
Practice Address - Phone:318-442-0243
Practice Address - Fax:318-442-2406
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2014-08-12
Deactivation Date:2006-03-15
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
LA1071-114T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1442186Medicaid
LA1442186Medicaid
LAU24151Medicare UPIN