Organization
DAVID EDISON HARRIS
Active
Parent organization
DAVID EDISON HARRIS
Other names
Evergreen Regenerative Medicine & Rehabilitation
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVID EDISON HARRIS
Authorized official
DR. DAVID EDISON HARRIS DO (OWNER)
(541) 414-0450
Entity
Organization
Contact information
Practice address
707 MURPHY RD STE 101, MEDFORD, OR 97504-8520
(541) 414-0450
(541) 414-0455
Mailing address
707 MURPHY RD STE 101, MEDFORD, OR 97504-8520
(541) 414-0450
(541) 414-0455
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500679386
—
OR
Enumeration date
05/16/2020
Last updated
05/16/2020
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