MEDICARE: DAVID T. HARRISON, D.O.,P.C.

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
1	208C00000X	Colon & Rectal Surgery Physician	02000816	IN

General Provider Information

NPI Number	:	1033399704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID T. HARRISON, D.O.,P.C.

Provider Business Mailing Address
First Line	:	3520 GUION RD STE 307
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-1672
Country	:	US
Telephone Number	:	317-923-1033
Fax Number	:	317-927-7426

Provider Business Practice Location Address
First Line	:	3520 GUION RD STE 307
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-1672
Country	:	US
Telephone Number	:	317-923-1033
Fax Number	:	317-927-7426

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID THOMAS HARRISON
Credential	:	D.O.
Telephone Number	:	317-923-1033

Provider Enumeration Date	:	11/09/2007
Last Update Date	:	11/09/2007

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