Healthcare Provider Details

I. General information

NPI: 1912057894
Provider Name (Legal Business Name): JAMES HARKNESS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2621
US

IV. Provider business mailing address

38 LAMOINE ST
BELMONT MA
02478-2629
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-5845
  • Fax:
Mailing address:
  • Phone: 617-480-7712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number237855
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: