Provider Demographics
NPI:1245228097
Name:HARVEY, REGINA R (OD)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:R
Last Name:HARVEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:REGINA
Other - Middle Name:R
Other - Last Name:HOBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:373 MERIDIAN PARKE LN STE E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-9419
Mailing Address - Country:US
Mailing Address - Phone:317-535-3935
Mailing Address - Fax:317-535-3905
Practice Address - Street 1:373 MERIDIAN PARKE LN STE E
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-9419
Practice Address - Country:US
Practice Address - Phone:317-535-3935
Practice Address - Fax:317-886-4945
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003166152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5767090001Medicare NSC
IN247470AMedicare PIN
INU93789Medicare UPIN