Individual
DR. JON DAVID HEAVERLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
131 N MAIN ST, CHARITON, IA 50049-1270
(641) 774-7507
(641) 774-0466
Mailing address
915 N 5TH ST, CHARITON, IA 50049-1238
(641) 774-7507
(641) 774-0466
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02187
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0277610001
CMERC OVC
IA
01
—
0277610002
DMERC CVC
IA
01
—
0277610004
DMERC OTT
IA
01
—
26830
BCBS OSCEOLA
IA
01
—
26834
BCBS CHARITON
IA
01
—
34213
BCBS OTTUMWA
IA
05
—
5219121
—
IA
05
—
6219121
—
IA
05
—
821921
—
IA
Enumeration date
04/19/2006
Last updated
09/27/2007
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