Provider Demographics
NPI:1154435998
Name:HARMON, DANIEL J (OD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:HARMON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S HOWARD ST
Mailing Address - Street 2:#A
Mailing Address - City:FLORA
Mailing Address - State:IN
Mailing Address - Zip Code:46929-9626
Mailing Address - Country:US
Mailing Address - Phone:574-967-4221
Mailing Address - Fax:
Practice Address - Street 1:103 S HOWARD ST
Practice Address - Street 2:#A
Practice Address - City:FLORA
Practice Address - State:IN
Practice Address - Zip Code:46929-9626
Practice Address - Country:US
Practice Address - Phone:574-967-4221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001777A/B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100070320AMedicaid
IN100070320AMedicaid
IN0493570001Medicare NSC
IN107030Medicare PIN