Individual
DAVID THOMAS HARRISON
Active
Individual
DAVID THOMAS HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
02000816
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000727646
BCBS
IN
05
—
100218030
—
IN
05
—
100218030A
—
IN
01
—
P01424321
RAIL ROAD PTAN
IN
Enumeration date
04/20/2006
Last updated
02/07/2024
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