Provider Demographics
NPI:1164436721
Name:HARMON, TOBY ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:TOBY
Middle Name:ALAN
Last Name:HARMON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-1330
Mailing Address - Country:US
Mailing Address - Phone:812-634-6363
Mailing Address - Fax:812-634-7373
Practice Address - Street 1:2602 NEWTON ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-1330
Practice Address - Country:US
Practice Address - Phone:812-634-6363
Practice Address - Fax:812-634-7373
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001808A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000184388OtherANTHEM
000000184388OtherANTHEM
143650BMedicare ID - Type Unspecified