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General NPI Number Information
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NPI Number | 1659770733
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Entity Type | Organization
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Legal Business Name | SCOTT C HARRIS DO PLLC
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 12/08/2014
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Provider Practice Location Address
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Address Line | 112 WINDMERE DR
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City | BOWLING GREEN
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State | KY
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Zip | 42103-8720
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Country | US
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Telephone | 231-740-1887
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Fax |
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Provider Business Mailing Address
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Address Line | 112 WINDMERE DR
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City | BOWLING GREEN
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State | KY
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Zip | 42103-8720
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Country | US
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Telephone | 231-740-1887
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | SCOTT C HARRIS
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Credential | DO
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Telephone | 517-899-2175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 03421
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License Number State | KY
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