Provider Demographics
NPI:1437234903
Name:HARRIS, JOHN PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PHILIP
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8001 YOUREE DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-2302
Mailing Address - Country:US
Mailing Address - Phone:318-212-3456
Mailing Address - Fax:318-212-3885
Practice Address - Street 1:8001 YOUREE DR
Practice Address - Street 2:SUITE 400
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-2302
Practice Address - Country:US
Practice Address - Phone:318-212-3456
Practice Address - Fax:318-212-3885
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2017-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA019188207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB63931Medicare UPIN
LA52531Medicare PIN
LA52531D829Medicare PIN