Provider Demographics
NPI:1457621344
Name:WILLIAM F HARVEY OD LTD
Entity type:Organization
Organization Name:WILLIAM F HARVEY OD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-384-1630
Mailing Address - Street 1:815 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-6909
Mailing Address - Country:US
Mailing Address - Phone:702-384-1630
Mailing Address - Fax:702-477-7756
Practice Address - Street 1:815 S 7TH ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6909
Practice Address - Country:US
Practice Address - Phone:702-384-1630
Practice Address - Fax:702-477-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV160152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVDS3640Medicare PIN
NV1260530001Medicare NSC
NVT-67233Medicare UPIN
NVFR739AMedicare PIN