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NPI Code Detail

MEDICARE: GARY M HARRELL MD

MEDICARE: GARY M HARRELL MD
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
1207Q00000XFamily Medicine Physician35065157OH

Other Identifiers

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

General Provider Information

NPI Number : 1780624932
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY M HARRELL MD
Provider Business Mailing Address
First Line : 8337 WYCLIFFE DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45244-2597
Country : US
Telephone Number : 513-272-1958
Fax Number :
Provider Business Practice Location Address
First Line : 989 MEDICAL PARK DR
Second Line :
City : MAYSVILLE
State : KY
Zip : 41056-8750
Country : US
Telephone Number : 606-759-3180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 07/08/2007

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