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NPI Code Detail

MEDICARE: MR. DAVID TYRONE HARPER

MEDICARE:  MR. DAVID TYRONE HARPER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5255AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17725454OTHERAZAETNA
2AZ0401980OTHERAZBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1336141514
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID TYRONE HARPER
Provider Business Mailing Address
First Line : 41818 N VENTURE DR
Second Line : STE 120
City : ANTHEM
State : AZ
Zip : 85086-3188
Country : US
Telephone Number : 623-742-7338
Fax Number : 623-742-7339
Provider Business Practice Location Address
First Line : 41818 N VENTURE DR
Second Line : STE 120
City : ANTHEM
State : AZ
Zip : 85086-3188
Country : US
Telephone Number : 623-742-7338
Fax Number : 623-742-7339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 06/26/2012

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Directions to “ MR. DAVID TYRONE HARPER ” Practice Location

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