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Individual

DR. MICHAEL THOMAS HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
201 S A ST, PENSACOLA, FL 32502-5554
(850) 460-8727
(850) 460-8725
Mailing address
1192 OLD TRL, GULF BREEZE, FL 32563-5536
(850) 460-8727
(850) 460-8725

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
4301087819
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME109777
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003653200
FL
05
129643
AL
01
14E22
BLUE CROSS BLUE SHIELD
FL
01
592-15138
BLUE CROSS BLUE SHIELD
AL
01
P00980670
MEDICARE RAILROAD
Enumeration date
03/16/2007
Last updated
05/31/2022
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