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Individual

SCOTT S. HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
211 FOREST ST, MCCALL, ID 83638-5256
(208) 634-2225
(208) 634-7212
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M5679
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010003561
BS PLMC
ID
01
000010003562
BS MVMC
ID
05
003736800
ID
01
080036078
RRMCR
ID
01
104462
DOL WA PLMC
WA
01
200548
DOL WA MVMC
WA
01
56796
BC PLMC
ID
01
D7019
BC MVMC
ID
Enumeration date
02/09/2007
Last updated
08/09/2013
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