Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 16164 | MS |
NPI | 1184614984 |
---|---|
Provider Name | Harvie D Harrier |
First Address | Indianola, MS 38751-2443 |
Second Address | Indianola, MS 38751-2443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 09/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00123356 | (05) | MS |
D99763 | (02) |