Provider Demographics
NPI:1255339610
Name:HARR, WILLIAM A (DPM)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:HARR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 HIGHWAY A1A
Mailing Address - Street 2:SUITE 101
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3581
Mailing Address - Country:US
Mailing Address - Phone:321-777-4774
Mailing Address - Fax:321-777-4788
Practice Address - Street 1:2020 HIGHWAY A1A
Practice Address - Street 2:SUITE 101
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3581
Practice Address - Country:US
Practice Address - Phone:321-777-4774
Practice Address - Fax:321-777-4788
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2015-01-20
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-30
Provider Licenses
StateLicense IDTaxonomies
FLPO1681213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029715100Medicaid
FL0580310002OtherDMERC
FL0580310002OtherDMERC
FL87924Medicare ID - Type Unspecified