Healthcare Provider Details

I. General information

NPI: 1245568666
Provider Name (Legal Business Name): HARRY DEBUTTS DO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 04/25/2022
Certification Date: 04/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 KELLEHER DR
LANDENBERG PA
19350-1365
US

IV. Provider business mailing address

401 HORSHAM RD SUITE 100
HORSHAM PA
19044-2013
US

V. Phone/Fax

Practice location:
  • Phone: 484-944-1551
  • Fax: 484-944-1527
Mailing address:
  • Phone: 484-944-1551
  • Fax: 484-944-1527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: HARRY ASHBY DEBUTTS
Title or Position: OWNER
Credential: DO
Phone: 610-662-9665