Provider Demographics
NPI:1932469871
Name:HARRIS, LAFE NELSON (DO)
Entity Type:Individual
Prefix:DR
First Name:LAFE
Middle Name:NELSON
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:91-2135 FORT WEAVER RD FL 4
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1940
Mailing Address - Country:US
Mailing Address - Phone:808-691-3883
Mailing Address - Fax:808-691-3884
Practice Address - Street 1:91-2135 FORT WEAVER RD FL 4
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1940
Practice Address - Country:US
Practice Address - Phone:808-691-3883
Practice Address - Fax:808-691-3884
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT9355610-1204207QS0010X
AZ006235207QS0010X
HIDOS-2354207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine