Provider Demographics
NPI:1467559088
Name:HARP, JONATHAN GUY (OD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:GUY
Last Name:HARP
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 1:1809 BRITTON DR
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36870-3447
Mailing Address - Country:US
Mailing Address - Phone:706-570-3301
Mailing Address - Fax:
Practice Address - Street 1:3700 HIGHWAY 431 N
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-2362
Practice Address - Country:US
Practice Address - Phone:334-291-6379
Practice Address - Fax:334-291-9109
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-886-TA-479152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist