# JACK ANDREW HARVEY DPM, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689052482
- **Authorized official:** DR. JACK ANDREW HARVEY DPM (PRESIDENT)
- **Authorized official phone:** (209) 823-2700

## Contact information

- **Practice address:** 1210 E NORTH ST, MANTECA, CA 95336-4962
- **Practice address phone:** (209) 823-2700
- **Practice address fax:** (209) 823-2779
- **Mailing address:** 1210 E NORTH ST, MANTECA, CA 95336-4962
- **Mailing address phone:** (209) 823-2700
- **Mailing address fax:** (209) 823-2779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | E5204 | CA | Yes |

## Other

- **Enumeration date:** 05/12/2015
- **Last updated:** 05/21/2015