Individual
JON HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
T-2804
MS
2086S0129X
Vascular Surgery Physician
Primary
26654
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06231763
—
MS
Enumeration date
05/27/2014
Last updated
09/01/2022
Update your record
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