Organization
KENNETH A. HARRIS, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL M SHANAHAN (BILLING MANAGER)
(623) 974-6611
Entity
Organization
Contact information
Practice address
10503 W THUNDERBIRD BLVD, # 313, SUN CITY, AZ 85351-3022
(623) 933-3865
(623) 933-1413
Mailing address
10503 W THUNDERBIRD BLVD, # 313, SUN CITY, AZ 85351-3022
(623) 933-3865
(623) 933-1413
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
13481
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215067533
INDIVIDUAL NPI
AZ
Enumeration date
06/26/2007
Last updated
12/13/2007
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