Provider Demographics
NPI:1205218393
Name:HARRISON, HUNTER (DO)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:
Last Name:HARRISON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:318-966-6535
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:200 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5359
Practice Address - Country:US
Practice Address - Phone:318-966-6535
Practice Address - Fax:318-322-7319
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS24855207Q00000X
LA331368207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine