MEDICARE: DR. BRYAN D. HARRIS 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	208M00000X	Hospitalist Physician	MD20509	OR
2	207R00000X	Internal Medicine Physician	MD20509	OR

General Provider Information

NPI Number	:	1700820636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN D. HARRIS M.D.

Provider Business Mailing Address
First Line	:	775 SW 9TH ST
Second Line	:	SUITE B
City	:	NEWPORT
State	:	OR
Zip	:	97365-4895
Country	:	US
Telephone Number	:	541-265-2007
Fax Number	:	541-265-3533

Provider Business Practice Location Address
First Line	:	2500 NE NEFF ROAD
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701
Country	:	US
Telephone Number	:	541-706-5811
Fax Number	:	541-706-5867

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	04/20/2020

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