Richard S Harris, DO | |
550 Mirabeau St, Greenfield, OH 45123-1617 | |
(937) 981-2116 | |
(937) 981-9238 |
Full Name | Richard S Harris |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 550 Mirabeau St, Greenfield, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811945801 | NPI | - | NPPES |
000000319610 | Other | BLUE CROSS BLUE SHIELD | |
0631990 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 34004098H (Ohio) | Primary |
Entity Name | Southwestern Recovery Center, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295241933 PECOS PAC ID: 5294095956 Enrollment ID: O20180129001817 |
Mailing Address | Practice Location Address |
---|---|
Richard S Harris, DO 4750 Hempstead Station Dr, Kettering, OH 45429-5164 Ph: (800) 875-0136 | Richard S Harris, DO 550 Mirabeau St, Greenfield, OH 45123-1617 Ph: (937) 981-2116 |
Mrs. Esther Grace Pablo Kanayjorn, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 1092 Jefferson St, Greenfield, OH 45123 Phone: 937-981-1121 Fax: 937-981-5660 | |
Jornel Rivera, DO Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 550 Mirabeau St, Greenfield, OH 45123 Phone: 937-981-2116 Fax: 937-981-9238 |