Provider Demographics
NPI:1538504832
Name:THOMAS G. HARBERT
Entity Type:Organization
Organization Name:THOMAS G. HARBERT
Other - Org Name:HARBERT ORTHOPEDICS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:HARBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-229-0205
Mailing Address - Street 1:201 S LLOYD ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4552
Mailing Address - Country:US
Mailing Address - Phone:605-229-0205
Mailing Address - Fax:605-229-5513
Practice Address - Street 1:201 S LLOYD ST
Practice Address - Street 2:SUITE 110
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4552
Practice Address - Country:US
Practice Address - Phone:605-229-0205
Practice Address - Fax:605-229-5513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4602207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDG36474Medicare UPIN