Provider Demographics
NPI:1245568666
Name:HARRY DEBUTTS DO, LLC
Entity Type:Organization
Organization Name:HARRY DEBUTTS DO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:ASHBY
Authorized Official - Last Name:DEBUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-662-9665
Mailing Address - Street 1:401 HORSHAM RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2013
Mailing Address - Country:US
Mailing Address - Phone:484-944-1551
Mailing Address - Fax:484-944-1527
Practice Address - Street 1:505 KELLEHER DR
Practice Address - Street 2:
Practice Address - City:LANDENBERG
Practice Address - State:PA
Practice Address - Zip Code:19350-1365
Practice Address - Country:US
Practice Address - Phone:484-944-1551
Practice Address - Fax:484-944-1527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H32267Medicare UPIN