| Dr Harry Taylor Harness, DO | |
|
315 West Mulberry Street, Pilot Knob, MO 63663 | |
| (573) 546-0602 | |
| (573) 546-0624 |
| Full Name | Dr Harry Taylor Harness |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 315 West Mulberry Street, Pilot Knob, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992819627 | NPI | - | NPPES |
| 002357 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 235 (South Carolina) | Secondary |
| 207Q00000X | Family Medicine | R9682 (Missouri) | Primary |
| 207Q00000X | Family Medicine | DO0000000858 (Tennessee) | Secondary |
| Entity Name | Big Springs Medical Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225045321 PECOS PAC ID: 6709871007 Enrollment ID: O20040416000695 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Harry Taylor Harness, DO 1500 N Westwood Blvd, P.o. Box 327, Poplar Bluff, MO 63901-3318 Ph: (573) 778-4760 | Dr Harry Taylor Harness, DO 315 West Mulberry Street, Pilot Knob, MO 63663 Ph: (573) 546-0602 |
Vatana C. Boonyasai, M.D/ Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 200 St.mary's Street, Lower Level, Pilot Knob, MO 63650 Phone: 573-546-3929 Fax: 573-546-3962 | |
Boonfu Boonyasai, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 200 St. Marys Street, Lower Level, Pilot Knob, MO 63663 Phone: 573-546-3929 Fax: 573-546-3962 |