| Michael T Harris Md, Pc | |
|
3422 S 15th E Idaho Falls ID 83404-8262 | |
| (208) 552-1222 | |
| (208) 552-3377 |
| Full Name | Michael T Harris Md, Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3422 S 15th E, Idaho Falls, Idaho |
| Authorized Official Name and Position | Michael T Harris (OWNER/PRACTITIONER) |
| Authorized Official Contact | 2085521222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael T Harris Md, Pc 3422 S 15th E Idaho Falls ID 83404-8262 Ph: (208) 552-1222 | Michael T Harris Md, Pc 3422 S 15th E Idaho Falls ID 83404-8262 Ph: (208) 552-1222 |
| NPI Number | 1285621532 |
|---|---|
| Provider Enumeration Date | 10/03/2005 |
| Last Update Date | 11/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285621532 | NPI | - | NPPES |
| 003729200 | Medicaid | ID | |
| 000010000013 | Other | ID | BLUE SHEILD OF IDAHO |
| 72793 | Other | ID | BLUE CROSS OF IDAHO |
| P00077360 | Other | ID | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | M 6846 (Idaho) | Primary |
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