Provider Demographics
NPI:1871631788
Name:HARRISON MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:HARRISON MEMORIAL HOSPITAL
Other - Org Name:GERALD R. HARPEL, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARPEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-234-5555
Mailing Address - Street 1:1210 KY HIGHWAY 36E
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031
Mailing Address - Country:US
Mailing Address - Phone:859-234-5555
Mailing Address - Fax:
Practice Address - Street 1:1210 KY HIGHWAY 36E
Practice Address - Street 2:SUITE 1A
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031
Practice Address - Country:US
Practice Address - Phone:859-234-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65942740Medicaid
9484Medicare PIN