Individual
GARY HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
913 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2503
(877) 783-6257
Mailing address
PO BOX 950112, DEPT. #52387, LOUISVILLE, KY 40295-0112
(888) 400-8870
(317) 870-0499
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28520
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64285208
—
KY
Enumeration date
08/17/2006
Last updated
10/19/2007
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