Individual
HARRISON C PUTMAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7301 N KNOXVILLE AVE, PEORIA, IL 61614-2017
(309) 589-3233
(309) 683-4120
Mailing address
7301 N KNOXVILLE AVE, PEORIA, IL 61614-2017
(309) 589-3233
(309) 683-4120
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7215792
BCBS
—
Enumeration date
01/30/2006
Last updated
07/08/2007
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