Healthcare Provider Details

I. General information

NPI: 1043464951
Provider Name (Legal Business Name): BRANDON HARRIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7655 5 MILE RD STE 117
CINCINNATI OH
45230-4326
US

IV. Provider business mailing address

4603 BRIGHTON LN
WEST CHESTER OH
45069-8549
US

V. Phone/Fax

Practice location:
  • Phone: 136-247-5255
  • Fax: 513-624-0578
Mailing address:
  • Phone: 917-455-7724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number35.133702
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number35.133702
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: