Individual
JOHN S HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6420 DUTCHMANS PKWY, SUITE 200, LOUISVILLE, KY 40205-3372
(502) 891-8300
Mailing address
PO BOX 766351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
37909
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000293959
ANTHEM PIN
KY
01
—
000000693034
ANTHEM - NCVA
KY
01
—
000057080F
HUMANA - NCVA
KY
05
—
200440800A
—
IN
05
—
200440800F
—
IN
01
—
2442609000
PASSPORT ADVANTAGE PIN
KY
01
—
50000954
PASSPORT PIN
KY
01
—
50031148
PASSPORT & PASSPORT ADVTG - NCVA
KY
05
—
64064793
—
KY
01
—
P00889594
MEDICARE RR - NCVA
KY
Enumeration date
06/29/2006
Last updated
01/19/2021
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