MEDICARE: DR. HAROLD LOVELL HARRISON 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	208000000X	Pediatrics Physician	17968	KY
2	2080P0210X	Pediatric Nephrology Physician	17968	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1952500639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD LOVELL HARRISON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 909
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40201-0909
Country	:	US
Telephone Number	:	502-629-3972
Fax Number	:	502-629-7744

Provider Business Practice Location Address
First Line	:	234 E GRAY ST
Second Line	:	STE 270
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1903
Country	:	US
Telephone Number	:	502-629-3972
Fax Number	:	502-629-7744

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

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	09/09/2014

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