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General NPI Number Information
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NPI Number | 1558610675
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Entity Type | Organization
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Legal Business Name | DOUGLAS G. HARRISON MD, PC
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 2020 W 16TH ST
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City | SAFFORD
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State | AZ
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Zip | 85546-4026
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Country | US
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Telephone | 928-792-2060
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Fax | 928-458-7256
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Provider Business Mailing Address
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Address Line | PO BOX 2660
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City | THATCHER
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State | AZ
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Zip | 85552-2660
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Country | US
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Telephone | 928-792-2060
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Fax | 928-458-7256
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. DONNA HARRISON
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Credential |
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Telephone | 928-792-2060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 41204
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License Number State | AZ
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