Individual
RICHARD BOOTH HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1850 BLUEGRASS AVE, LOUISVILLE, KY 40215
(502) 361-6617
(502) 361-6637
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 361-6617
(502) 361-6637
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
006642
AZ
207L00000X
Anesthesiology Physician
Primary
04047
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300040126
—
IN
05
—
7100632660
—
KY
Enumeration date
05/11/2011
Last updated
07/15/2020
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