Individual provider Active NPI

Douglas G Harrison, MD

  • Obstetrics & Gynecology Physician
  • Safford, AZ
National Provider Identifier
1720065253
Registry record updated Nov 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
41204 Issued in AZ
Practice address
2020 W 16TH St
Safford, AZ 85546-4026
Phone
(928) 424-4444
Fax
(928) 424-4446
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 053918 GA
Obstetrics & Gynecology Physician 207V00000X 41204 AZ Primary

Addresses

Primary practice location

2020 W 16TH St
Safford, AZ 85546-4026

Mailing address

PO Box 2660
Thatcher, AZ 85552-2660
Phone (928) 424-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090505000126 AZ Practitioner - Obstetrics/Gynecology 0749238582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Texas Tech University Health Science Center School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mt Graham Regional Medical Center IncGroup PAC ID 6204822364, 64 clinicians

Practice addresses (Care Compare)

1600 S 20TH Ave
Safford, AZ 85546-4011
Phone (928) 348-4000

2175 W 16TH St
Safford, AZ 85546-0011
Phone (928) 348-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41204AZMDObstetrics & Gynecology Physician
053918GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mt Graham Regional Medical Center Inc CurrentSince Jan 8, 2023 Accepting new patients
Mt Graham Regional Medical Center Inc Past Accepting new patients
Privia Medical Group of Georgia LLC Family Medicine Past Accepting new patients
Old Capital Women'S Health Obstetrics & Gynecology PastSince Jan 1, 2007 Accepting new patients

Locations

2175 W 16th St
Unit D
Safford, AZ 85546
Phone (928) 348-1600

2020 W 16th St
Safford, AZ 85546
Phone (928) 348-8208

1600 S 20th Ave
Safford, AZ 85546
Phone (928) 348-4000

2175 W 16th St
Unit E
Safford, AZ 85546

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353110400000",
    "number": "1720065253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2660",
            "city": "THATCHER",
            "state": "AZ",
            "postal_code": "855522660",
            "telephone_number": "928-424-4444",
            "fax_number": "928-424-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W 16TH ST",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464026",
            "telephone_number": "928-424-4444",
            "fax_number": "928-424-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "DOUGLAS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2012-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "053918",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "41204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safford, AZ

Sources for this page

Verify at the official NPI Registry.