Provider Demographics
NPI:1114026853
Name:HARRIS, KEITH WEBB II (DO)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:WEBB
Last Name:HARRIS
Suffix:II
Gender:M
Credentials:DO
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Mailing Address - Street 1:500 COMMACK RD UNIT 206
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-5022
Mailing Address - Country:US
Mailing Address - Phone:631-675-2125
Mailing Address - Fax:631-675-2624
Practice Address - Street 1:1500 ROUTE 112 STE B
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-8055
Practice Address - Country:US
Practice Address - Phone:631-978-7633
Practice Address - Fax:631-621-4115
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2022-04-29
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Provider Licenses
StateLicense IDTaxonomies
NY236259-1207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease