Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 32405 | MO |
Y | 207QS0010X | Family Doctor - Sports Medicine | 32405 | MO |
NPI | 1174527873 |
---|---|
Provider Name | Dr. Patrick B. Harr |
First Address | Springfield, MO 65801-2580 |
Second Address | Shell Knob, MO 65747-7822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 30/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0991927 | (05) | IA |
1174527873 | (05) | MO |
194179001 | (05) | AR |
431560263 | TRICARE (01) | MO |
C51519 | (02) | MO |
P01091570 | RR MCR (01) | MO |