Individual
DR. TIMOTHY PAUL HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1301 W 12TH AVE STE 301, EMPORIA, KS 66801-2590
(620) 343-2376
(620) 342-0087
Mailing address
1201 W 12TH AVE, EMPORIA, KS 66801-2504
(620) 343-6800
(620) 341-7821
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0521008
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020015054
RAILROAD MEDICARE
—
05
—
100231930A
—
KS
Enumeration date
03/25/2006
Last updated
05/14/2019
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