Richard S Harris, DO
Individual provider Active NPI Internal Medicine Physician · Greenfield, OH
NPI 1811945801 · NPPES record last updated Oct 19, 2007
Key facts
- NPI
- 1811945801
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 34004098H (OH)
- Practice address
- 550 Mirabeau St
Greenfield, OH 45123-1617 - Phone
- (937) 981-2116
- Fax
- (937) 981-9238
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1891 | OH | MD | Chiropractor |
| 34004098H | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reach for Tomorrow Inc | Internal Medicine | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 34004098H | OH | Yes |
Addresses
Primary practice location
550 Mirabeau St
Greenfield, OH 45123-1617
Mailing address
4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000319610 | Other | BLUE CROSS BLUE SHIELD | |
| 0631990 | Medicaid | OH |
Other providers in Greenfield, OH
- Greenfield SNF, Inc.
- Becky Grooms
- Hope Renee Gunter
- Antone Lavar Hall
- Mark Hann
- Jordyn Hatfield
- McKenna Hatfield
- Jennell Margaret Hatmaker
- HC SNF LLC
- Hearth & Care of Greenfield LLC
All providers in Greenfield, OH · Internal Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.