Individual
STEPHEN OWEN HARKNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 FAIRWAY DR, SUITE 402, COVINGTON, LA 70433-7503
(985) 892-8959
(985) 892-8975
Mailing address
101 FAIRWAY DR, SUITE 402, COVINGTON, LA 70433-7503
(985) 892-8959
(985) 892-8975
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD.013676
LA
208600000X
Surgery Physician
ME96909
FL
2086S0129X
Vascular Surgery Physician
ME96909
FL
208C00000X
Colon & Rectal Surgery Physician
ME96909
FL
208D00000X
General Practice Physician
ME96909
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1319171
—
LA
05
—
277130600
—
FL
01
—
B64254
BCBS FL
FL
01
—
P00381699
RAILROAD MEDICARE
FL
Enumeration date
06/29/2006
Last updated
02/11/2022
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