Provider Demographics
NPI:1427001866
Name:HARLAN, JOHN T (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:HARLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 MORNING SUN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-8929
Mailing Address - Country:US
Mailing Address - Phone:513-523-2158
Mailing Address - Fax:513-523-0019
Practice Address - Street 1:5225 MORNING SUN RD
Practice Address - Street 2:SUITE A
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-8929
Practice Address - Country:US
Practice Address - Phone:513-523-2158
Practice Address - Fax:513-523-0019
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059204H207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0818888Medicaid
OHHA0701412Medicare ID - Type Unspecified
OH0818888Medicaid