Provider Demographics
NPI:1811944499
Name:HARRINGTON, PATRICIA L (DO)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 1ST AVE
Mailing Address - Street 2:STE A
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-2623
Mailing Address - Country:US
Mailing Address - Phone:620-225-1033
Mailing Address - Fax:620-227-8491
Practice Address - Street 1:2004 1ST AVE
Practice Address - Street 2:STE A
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2623
Practice Address - Country:US
Practice Address - Phone:620-225-1033
Practice Address - Fax:620-227-8491
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS520525174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20382588Medicaid
CO498518Medicare ID - Type Unspecified
KS102939Medicare ID - Type Unspecified
KSD17449Medicare UPIN