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General NPI Number Information
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NPI Number | 1720250616
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Entity Type | Organization
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Legal Business Name | KURT D. HARRISON. D.O., INC.
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 1922 GLEN SPRINGS DR.
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City | FREMONT
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State | OH
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Zip | 43420
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Country | US
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Telephone | 419-333-9026
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Fax | 419-333-9043
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Provider Business Mailing Address
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Address Line | 1922 GLEN SPRINGS DR.
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City | FREMONT
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State | OH
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Zip | 43420
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Country | US
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Telephone | 419-333-9026
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Fax | 419-333-9043
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Authorized Official
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Title or Position | OWNER
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Name | DR. KURT DUDLEY HARRISON
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Credential | D.O.
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Telephone | 419-333-9026
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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 | 34-00-7809-H
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 34007809H
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License Number State | OH
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