Provider Demographics
NPI:1285612341
Name:HARPER, JAMES L (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:HARPER
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:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47346-0226
Mailing Address - Country:US
Mailing Address - Phone:765-489-4463
Mailing Address - Fax:
Practice Address - Street 1:50 N PERRY ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47346-1223
Practice Address - Country:US
Practice Address - Phone:765-489-4463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001914A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100256590AMedicaid
IN903860Medicare PIN
IN100256590AMedicaid
INT35135Medicare UPIN