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General NPI Number Information
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NPI Number | 1356721617
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Entity Type | Individual
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Provider Name | MITCHELL CLARK HARRIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 18511 HIGHLANDER MEDICS ST
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City | FORT BLISS
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State | TX
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Zip | 79906-5327
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Country | US
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Telephone | 915-742-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 650 JOEL DR
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City | FORT CAMPBELL
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State | KY
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Zip | 42223-5318
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 56652
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | V6180
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 56652
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | V6180
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License Number State | TX
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