MEDICARE: DR. DONALD ALLEN HARPER 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	2085R0202X	Diagnostic Radiology Physician	054388	GA
2	2085R0202X	Diagnostic Radiology Physician	N-6521	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00095280	OTHER	GA	RR MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	989136	OTHER	GA	BCBS

General Provider Information

NPI Number	:	1942209747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD ALLEN HARPER M.D.

Provider Business Mailing Address
First Line	:	451 FOREST POND LN
Second Line	:
City	:	BENTON
State	:	AR
Zip	:	72019-7043
Country	:	US
Telephone Number	:	912-547-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 FORT ROOTS DR BLDG 66
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-1709
Country	:	US
Telephone Number	:	912-547-5511
Fax Number	:

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	03/17/2018

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Directions to “ DR. DONALD ALLEN HARPER M.D.” Practice Location

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