Provider Demographics
NPI:1750308102
Name:DR JOHN JANVIER & ASSOCIATES PC
Entity type:Organization
Organization Name:DR JOHN JANVIER & ASSOCIATES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:JANVIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:843-837-4545
Mailing Address - Street 1:3 MALPHRUS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-6635
Mailing Address - Country:US
Mailing Address - Phone:843-837-4545
Mailing Address - Fax:843-837-4474
Practice Address - Street 1:3 MALPHRUS RD STE 101
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-6635
Practice Address - Country:US
Practice Address - Phone:843-837-4545
Practice Address - Fax:843-837-4474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC0941152W00000X
SCSC551152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD05518Medicaid
SC=========OtherBCBS
SCD05518Medicaid
=========OtherTRICARE
SCD05518Medicaid