Organization
BEAVER POND BROOK EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL HARRIS MD (OFFICER)
(469) 401-2386
Entity
Organization
Contact information
Practice address
3081 E MAIN ST, WATERBURY, CT 06705-3424
(469) 401-2386
Mailing address
13737 NOEL RD STE 1600, DALLAS, TX 75240-1374
(469) 401-2386
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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