Healthcare Provider Details

I. General information

NPI: 1720191919
Provider Name (Legal Business Name): DOUGLASS MONROE HARMON JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

997 N MAIN ST
WASHINGTON PA
15301-2807
US

IV. Provider business mailing address

1505 FOX CHASE DR
SEWICKLEY PA
15143-8611
US

V. Phone/Fax

Practice location:
  • Phone: 412-502-5124
  • Fax: 855-476-8911
Mailing address:
  • Phone: 724-816-2977
  • Fax: 855-476-8911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberOS013439
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: