Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD20881 | OR |
NPI | 1073524278 |
---|---|
Provider Name | Garry Christopher Harris |
First Address | Medford, OR 97504-7715 |
Second Address | White City, OR 97503-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |