Individual
BRENTON LYNN HARRIS
Active
Individual
BRENTON LYNN HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01095516A
IN
2085R0202X
Diagnostic Radiology Physician
103216
GA
2085R0202X
Diagnostic Radiology Physician
Primary
36394
IA
2085R0202X
Diagnostic Radiology Physician
MD29130
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578773032
—
IA
01
—
72104
WELLMARK
IA
Enumeration date
05/23/2007
Last updated
04/27/2026
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