Provider Demographics
NPI:1700872488
Name:HARMAN, ERNEST LAVERE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:LAVERE
Last Name:HARMAN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3880 N STOCKTON HILL RD STE 103134
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-0595
Mailing Address - Country:US
Mailing Address - Phone:928-377-1615
Mailing Address - Fax:928-692-1888
Practice Address - Street 1:5036 STOCKTON HILL RD
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-1127
Practice Address - Country:US
Practice Address - Phone:928-377-1615
Practice Address - Fax:928-692-1888
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2022-02-11
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Provider Licenses
StateLicense IDTaxonomies
AZ246492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G26044Medicare UPIN
Z26226Medicare ID - Type Unspecified