Provider Demographics
NPI:1255417424
Name:HARRIS, RICHARD YARD (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:YARD
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 RAMPART RANGE RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-2416
Mailing Address - Country:US
Mailing Address - Phone:719-687-6088
Mailing Address - Fax:719-687-0940
Practice Address - Street 1:381 RAMPART RANGE RD
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-2416
Practice Address - Country:US
Practice Address - Phone:719-687-6088
Practice Address - Fax:719-687-0940
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18803208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
E06392Medicare UPIN
C39041Medicare ID - Type Unspecified