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General NPI Number Information
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NPI Number | 1962799460
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Entity Type | Individual
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Provider Name | TYLER JAMES HARRIS MD
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Gender | Male
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 04/18/2019
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Provider Practice Location Address
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Address Line | 1510 12TH AVE RD STE 100
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City | NAMPA
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State | ID
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Zip | 83686
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Country | US
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Telephone | 208-498-1333
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 POWELL ST STE 900
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City | EMERYVILLE
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State | CA
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Zip | 94608-1844
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Country | US
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Telephone | 510-350-2600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD180078
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4301099332
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M-12361
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License Number State | ID
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