Gary L Harris, MD
Individual provider Active NPI Family Medicine Physician · Smithfield, UT
NPI 1154330462 · NPPES record last updated Aug 18, 2008
Key facts
- NPI
- 1154330462
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1727361205 (UT)
- Practice address
- 502 S Main St
Smithfield, UT 84335-2314 - Phone
- (435) 563-3222
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080619000751 | UT | Practitioner - Family Practice | 7719058684 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1727361205 | UT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services Inc | Family Medicine | Current |
Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
502 S Main St
Smithfield, UT 84335
Phone (345) 752-8880
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1727361205 | UT | Yes |
Addresses
Primary practice location
502 S Main St
Smithfield, UT 84335-2314
Mailing address
502 S Main St
Smithfield, UT 84335-2314
Phone (435) 563-3222
Other providers in Smithfield, UT
- Jeremy David Gibbons
- Bruce H Godderidge
- Andrew Leo Hansen
- Jake Edwin Hansen
- Chad M. Harris
- Healthy Eyes of Cache Valley, PLLC
- David Wayne Hinkson
- Joshua Richard Hoopes
- House Call Physical Therapy LLC
- House Call Physical Therapy, LLC
All providers in Smithfield, UT · Family Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.