MEDICARE: DR. JOHN MORIN HARPENAU M.D.

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	207V00000X	Obstetrics & Gynecology Physician	23610	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215931985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN MORIN HARPENAU M.D.

Provider Business Mailing Address
First Line	:	2702 NORTH 3RD STREET
Second Line	:	SUITE 4020
City	:	PHOENIX
State	:	AZ
Zip	:	85004-4608
Country	:	US
Telephone Number	:	602-323-3344
Fax Number	:	602-323-3496

Provider Business Practice Location Address
First Line	:	6601 WEST THOMAS ROAD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033
Country	:	US
Telephone Number	:	602-243-7277
Fax Number	:	623-247-9742

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	12/21/2011

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