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NPI Code Detail

MEDICARE: TIMOTHY W HARRIS DO

MEDICARE: TIMOTHY W HARRIS DO
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
1207Q00000XFamily Medicine Physician25MB06944700NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447364294
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY W HARRIS DO
Provider Business Mailing Address
First Line : 860 S WHITE HORSE PIKE
Second Line :
City : HAMMONTON
State : NJ
Zip : 08037-2018
Country : US
Telephone Number : 609-567-0200
Fax Number : 609-704-1482
Provider Business Practice Location Address
First Line : 238 E BROADWAY
Second Line :
City : SALEM
State : NJ
Zip : 08079-1108
Country : US
Telephone Number : 856-935-7711
Fax Number : 856-935-9123
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 07/09/2007

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