Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1702DT | KY |
NPI | 1003080656 |
---|---|
Provider Name | Dr. Andrew Morgan Harvey |
First Address | Louisville, KY 40245-1901 |
Second Address | Louisville, KY 40245-1901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 10/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003080656 | NPI (01) | KY |
1790018034 | GROUP NPI (01) | KY |
7100041380 | (05) | KY |
7100100120 | GROUP MEDICAID (01) | KY |
P00920357 | RR MEDICARE (01) | KY |