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NPI Code Detail

MEDICARE: DR. JOHN R HARBOUR M.D.

MEDICARE: DR. JOHN R HARBOUR 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician0101237958VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871590109
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN R HARBOUR M.D.
Provider Business Mailing Address
First Line : PO BOX 5468
Second Line :
City : MARTINSVILLE
State : VA
Zip : 24115-5468
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5801 BREMO RD
Second Line :
City : RICHMOND
State : VA
Zip : 23226-1907
Country : US
Telephone Number : 804-281-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2005
Last Update Date : 04/30/2015

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