Provider Demographics
NPI:1699027201
Name:ERNEST L HARMAN MD ZIA WAY LLC
Entity Type:Organization
Organization Name:ERNEST L HARMAN MD ZIA WAY LLC
Other - Org Name:ZIA WAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:LAVERE
Authorized Official - Last Name:HARMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:628-377-1615
Mailing Address - Street 1:3880 N STOCKTON HILL RD STE 103134
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-0595
Mailing Address - Country:US
Mailing Address - Phone:928-377-1615
Mailing Address - Fax:928-692-1888
Practice Address - Street 1:5036 STOCKTON HILL RD
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-1127
Practice Address - Country:US
Practice Address - Phone:928-377-1615
Practice Address - Fax:928-692-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ246492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty