Individual
EDWARD PRICE ODELL HARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2499
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036135492
IL
2085R0202X
Diagnostic Radiology Physician
2014026431
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036135492
—
IL
Enumeration date
06/25/2008
Last updated
08/22/2022
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