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General NPI Number Information
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NPI Number | 1750598108
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Entity Type | Organization
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Legal Business Name | DR GERALD B HARRIS II LLC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 10615 W. THUNDERBIRD STE. B-200
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City | SUN CITY
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State | AZ
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Zip | 85351-3055
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Country | US
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Telephone | 623-977-0700
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Fax | 623-977-2315
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Provider Business Mailing Address
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Address Line | 10930 W CAMBRIDGE AVE
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City | AVONDALE
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State | AZ
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Zip | 85323-5905
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Country | US
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Telephone | 623-977-0700
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Fax | 623-977-2315
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Authorized Official
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Title or Position | OWNER
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Name | DR. GERALD BARNES HARRIS II
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Credential | D.O.
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Telephone | 623-977-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4027
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License Number State | AZ
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