Provider Demographics
NPI:1841394038
Name:HARRIS, MILTON LANIER JR (MD)
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:LANIER
Last Name:HARRIS
Suffix:JR
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 1:3500 N CAUSEWAY BLVD
Mailing Address - Street 2:SUITE 1410
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-838-9919
Mailing Address - Fax:504-834-3101
Practice Address - Street 1:3500 N CAUSEWAY BLVD
Practice Address - Street 2:SUITE 1410
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-838-9919
Practice Address - Fax:504-834-3101
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0171412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA19075907Medicaid
LA19075907Medicaid
B64141Medicare UPIN