Provider Demographics
NPI: | 1861628273 |
---|---|
Name: | JOHN T. LOVAS, O.D., LLC |
Entity type: | Organization |
Organization Name: | JOHN T. LOVAS, O.D., LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | THOMAS |
Authorized Official - Last Name: | LOVAS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OD |
Authorized Official - Phone: | 419-578-0057 |
Mailing Address - Street 1: | 3454 OAK ALLEY CT |
Mailing Address - Street 2: | SUITE 202 |
Mailing Address - City: | TOLEDO |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43606-1306 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 419-578-0057 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3454 OAK ALLEY CT |
Practice Address - Street 2: | SUITE 202 |
Practice Address - City: | TOLEDO |
Practice Address - State: | OH |
Practice Address - Zip Code: | 43606-1306 |
Practice Address - Country: | US |
Practice Address - Phone: | 419-578-0057 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-06-01 |
Last Update Date: | 2009-06-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | 5560 | 152W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |