Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 241712 | NY |
Y | 207X00000X | Orthopaedic Surgeon | ME110018 | FL |
N | 207XS0106X | Orthopaedic Hand Surgeon | 241712 | NY |
N | 207XS0106X | Orthopaedic Hand Surgeon | ME110018 | FL |
NPI | 1013187681 |
---|---|
Provider Name | Dr. Richard James Harrison JR. |
First Address | Melbourne, FL 32901-1938 |
Second Address | Melbourne, FL 32901-1938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2008 |
Last Update Date | 16/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007050300 | MEDICAID NON FFS (01) | FL |
1483327 | CIGNA (01) | FL |
14H4N | FLORIDA BLUE (01) | FL |
2300218 | COVENTRY (01) | FL |
901776 | AETNA (01) | FL |
P01256129 | RAILROAD MEDICARE (01) | FL |