MEDICARE: DR. MARK KEVIN HARMON M.D.

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
1	207W00000X	Ophthalmology Physician	H7063	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1932102290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK KEVIN HARMON M.D.

Provider Business Mailing Address
First Line	:	3345 PLAZA 10 DR
Second Line	:	SUITE B
City	:	BEAUMONT
State	:	TX
Zip	:	77707-2553
Country	:	US
Telephone Number	:	409-833-0444
Fax Number	:	409-833-9039

Provider Business Practice Location Address
First Line	:	3345 PLAZA 10 DR
Second Line	:	STE B
City	:	BEAUMONT
State	:	TX
Zip	:	77707-2553
Country	:	US
Telephone Number	:	409-833-0444
Fax Number	:	409-833-9039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	10/02/2012

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