Individual
GENIEL HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 200-5383
Mailing address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 200-5383
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
42770
AZ
207Q00000X
Family Medicine Physician
11036
ND
207Q00000X
Family Medicine Physician
50846
MN
207Q00000X
Family Medicine Physician
7267
SD
207QA0505X
Adult Medicine Physician
Primary
42770
AZ
Other
Enumeration date
01/04/2008
Last updated
03/24/2015
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