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General NPI Number Information
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NPI Number | 1255396255
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Entity Type | Individual
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Provider Name | DAVID THOMAS HARRISON DO
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Gender | Male
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 3660 GUION RD STE 330
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-1697
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Country | US
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Telephone | 317-923-1033
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Fax | 317-927-7426
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Provider Business Mailing Address
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Address Line | 8314 EAGLE CREST LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46234-9528
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 02000816
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License Number State | IN
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