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NPI Code Detail

MEDICARE: KURT GENE HARRIS MD

MEDICARE: KURT GENE HARRIS MD
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
12085R0202XDiagnostic Radiology Physician38763WI

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 : 1902859721
Entity Type Code : Individual
Provider Name (Legal Business Name) : KURT GENE HARRIS MD
Provider Business Mailing Address
First Line : 228 S 18TH AVE
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-1000
Country : US
Telephone Number : 920-746-9729
Fax Number : 920-746-9881
Provider Business Practice Location Address
First Line : 228 S 18TH AVE
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-1000
Country : US
Telephone Number : 920-746-9729
Fax Number : 920-746-9881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 07/08/2007

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