Provider Demographics
NPI:1851531941
Name:DJ GROUP, LLC
Entity Type:Organization
Organization Name:DJ GROUP, LLC
Other - Org Name:DR. JOSEPH E. LAVAUX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAVAUX
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:520-881-2188
Mailing Address - Street 1:440 N ALVERNON WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1958
Mailing Address - Country:US
Mailing Address - Phone:520-881-2188
Mailing Address - Fax:520-327-6546
Practice Address - Street 1:440 N ALVERNON WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1958
Practice Address - Country:US
Practice Address - Phone:520-881-2188
Practice Address - Fax:520-327-6546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1659152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty