Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD015680 | LA |
NPI | 1003844283 |
---|---|
Provider Name | Eugene Anthony Harris JR. |
First Address | New Orleans, LA 70121 |
Second Address | New Orleans, LA 70121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 29/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04057261 | (05) | MS |
1357740 | (05) | LA |
F07716 | (02) |