Provider Demographics
NPI:1649262221
Name:HARRIS, FRIEDRICHS HENRY JR (MD)
Entity type:Individual
Prefix:
First Name:FRIEDRICHS
Middle Name:HENRY
Last Name:HARRIS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:HENRY
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4409 UTICA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-6530
Mailing Address - Country:US
Mailing Address - Phone:504-457-3687
Mailing Address - Fax:504-620-0250
Practice Address - Street 1:4409 UTICA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-6530
Practice Address - Country:US
Practice Address - Phone:504-457-3687
Practice Address - Fax:504-620-0250
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013677207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1361194Medicaid
LA390001068OtherRAILROAD MEDICARE #
LA5237276OtherCIGNA PROVIDER #
LA0690612OtherAETNA PROVIDER #
LA1946095Medicaid
LAD79734Medicare UPIN
LA5M818Medicare ID - Type UnspecifiedMEDICARE #
LA1361194Medicaid