Michael T Harris Md, Pc | |
3422 S 15th E Idaho Falls ID 83404-8262 | |
(208) 552-1222 | |
(208) 552-3377 |
Full Name | Michael T Harris Md, Pc |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 3422 S 15th E, Idaho Falls, Idaho |
Authorized Official Name and Position | Michael T Harris (OWNER/PRACTITIONER) |
Authorized Official Contact | 2085521222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Michael T Harris Md, Pc 3422 S 15th E Idaho Falls ID 83404-8262 Ph: (208) 552-1222 | Michael T Harris Md, Pc 3422 S 15th E Idaho Falls ID 83404-8262 Ph: (208) 552-1222 |
NPI Number | 1285621532 |
---|---|
Provider Enumeration Date | 10/03/2005 |
Last Update Date | 11/22/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285621532 | NPI | - | NPPES |
003729200 | Medicaid | ID | |
000010000013 | Other | ID | BLUE SHEILD OF IDAHO |
72793 | Other | ID | BLUE CROSS OF IDAHO |
P00077360 | Other | ID | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | M 6846 (Idaho) | Primary |
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