Provider Demographics
NPI:1285070037
Name:ALAVANJA, JOVAN (OD)
Entity type:Individual
Prefix:
First Name:JOVAN
Middle Name:
Last Name:ALAVANJA
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 1:446 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-2390
Mailing Address - Country:US
Mailing Address - Phone:219-789-9775
Mailing Address - Fax:
Practice Address - Street 1:10823 BROADWAY
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7303
Practice Address - Country:US
Practice Address - Phone:219-310-8032
Practice Address - Fax:219-789-9775
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003775A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist