Provider Demographics
NPI:1447612833
Name:KURT D HARRISON DOPC
Entity Type:Organization
Organization Name:KURT D HARRISON DOPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:419-333-9026
Mailing Address - Street 1:1922 GLEN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-3229
Mailing Address - Country:US
Mailing Address - Phone:419-333-9026
Mailing Address - Fax:419-333-9043
Practice Address - Street 1:1922 GLEN SPRINGS DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-3229
Practice Address - Country:US
Practice Address - Phone:419-333-9026
Practice Address - Fax:419-333-9043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18725-NP261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care