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General NPI Number Information
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NPI Number | 1083784359
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Entity Type | Organization
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Legal Business Name | DAVID L HARRIS MD LTD
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 95 HARRIS DR BUILDING 3
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City | KILMARNOCK
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State | VA
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Zip | 22482
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Country | US
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Telephone | 804-435-1661
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Fax | 804-435-0117
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Provider Business Mailing Address
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Address Line | PO BOX 1449 95 HARRIS DR
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City | KILMARNOCK
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State | VA
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Zip | 22482-1449
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Country | US
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Telephone | 804-435-1661
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Fax | 804-435-0117
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Authorized Official
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Title or Position | OFFICE MANAGER PROPRIETOR
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Name | DAVID LEA HARRIS
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Credential | OFFICE PROPRIETOR MD
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Telephone | 804-435-1661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0101023906
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License Number State | VA
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