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NPI Code Detail

MEDICARE: DENA AMERINE HARRIS PA

MEDICARE: DENA AMERINE HARRIS PA
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
1152W00000XOptometrist2339AR

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 : 1801875794
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENA AMERINE HARRIS PA
Provider Business Mailing Address
First Line : 4900 ROGERS AVE STE 103A
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-2068
Country : US
Telephone Number : 479-452-8200
Fax Number : 479-452-6779
Provider Business Practice Location Address
First Line : 4900 ROGERS AVE STE 103A
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-2068
Country : US
Telephone Number : 479-452-8200
Fax Number : 479-452-6779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2006
Last Update Date : 04/14/2011

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Directions to “ DENA AMERINE HARRIS PA” Practice Location

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