Provider Demographics
NPI:1851333660
Name:HARRIS, NEIL D (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:D
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NEIL
Other - Middle Name:DAVID
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7580 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2307
Mailing Address - Country:US
Mailing Address - Phone:520-547-2517
Mailing Address - Fax:520-547-2518
Practice Address - Street 1:6200 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3529
Practice Address - Country:US
Practice Address - Phone:520-469-8014
Practice Address - Fax:520-469-8009
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33745207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ33745OtherLICENSE
AZ33745OtherLICENSE