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NPI Code Detail

MEDICARE: MR. DEWITT TYLER HARRISON

MEDICARE: MR. DEWITT TYLER HARRISON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramLA
2207R00000XInternal Medicine Physician326433LA

General Provider Information

NPI Number : 1023316403
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DEWITT TYLER HARRISON
Provider Business Mailing Address
First Line : 1514 JEFFERSON HWY
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70121-2429
Country : US
Telephone Number : 504-842-4000
Fax Number :
Provider Business Practice Location Address
First Line : 1514 JEFFERSON HWY
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70121-2483
Country : US
Telephone Number : 504-842-4135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2011
Last Update Date : 09/07/2022

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Directions to “ MR. DEWITT TYLER HARRISON ” Practice Location

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