Individual
DR. JONATHAN ELLIOT HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
615 S NEW BALLAS RD DEPT OF, SAINT LOUIS, MO 63141-8221
(314) 251-6000
(636) 386-7679
Mailing address
339 CONSORT DR, BALLWIN, MO 63011-4439
(636) 386-9224
(636) 386-9224
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2019024440
MO
390200000X
Student in an Organized Health Care Education/Training Program
049753251
GA
Other
Enumeration date
05/09/2014
Last updated
08/01/2019
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