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General NPI Number Information
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NPI Number | 1588722375
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Entity Type | Organization
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Legal Business Name | HARRISON EYE CENTER, P.C.
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 435 CHERRY ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4672
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Country | US
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Telephone | 616-776-0016
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Fax |
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Provider Business Mailing Address
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Address Line | 435 CHERRY ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503
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Country | US
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Telephone | 616-776-0016
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. MICHAEL DEBRE' HARRISON
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Credential | M.D.
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Telephone | 616-776-0016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4301061087
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License Number State | MI
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