Mark A Havera, OD

NPI #1306125166 in Edwardsville, Illinois

Provider Information

NPI Number: 1306125166
Entity Type: Individual
Name: Mark A Havera, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Aug 11, 2011
Last Updated: Oct 2, 2014

Practice Location

Address: 6663 EDWARDSVILLE CROSSING DR
Address 2: STE B
City: Edwardsville
State: Illinois
ZIP Code: 62025-2704
Phone: (618) 659-2320

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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