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NPI Code Detail

MEDICARE: RICHARD S HARRIS DO

MEDICARE: RICHARD S HARRIS DO
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
1207R00000XInternal Medicine Physician34004098HOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000319610OTHERBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811945801
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD S HARRIS DO
Provider Business Mailing Address
First Line : 4750 HEMPSTEAD STATION DR
Second Line :
City : KETTERING
State : OH
Zip : 45429-5164
Country : US
Telephone Number : 800-875-0136
Fax Number : 937-619-4231
Provider Business Practice Location Address
First Line : 550 MIRABEAU ST
Second Line :
City : GREENFIELD
State : OH
Zip : 45123-1617
Country : US
Telephone Number : 937-981-2116
Fax Number : 937-981-9238
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 10/19/2007

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