Individual
MARK E HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 N CARRIAGE PKWY, WICHITA, KS 67208-4501
(316) 962-3100
(316) 962-3192
Mailing address
620 N CARRIAGE PKWY, WICHITA, KS 67208-4501
(316) 962-3100
(316) 962-3192
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0429569
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100456510A
—
KS
01
—
102992
BCBS
KS
Enumeration date
02/15/2006
Last updated
01/27/2022
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