Provider Demographics
NPI:1023135050
Name:KORVER, JOHN CHARLES
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:KORVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3539 SOUTHERN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4750
Mailing Address - Country:US
Mailing Address - Phone:712-276-2323
Mailing Address - Fax:712-274-9986
Practice Address - Street 1:3539 SOUTHERN HILLS DR
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4750
Practice Address - Country:US
Practice Address - Phone:712-276-2323
Practice Address - Fax:712-274-9986
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician