1710189709 NPI number — DR. JOHN THOMAS HARRIS M.D.

Table of content: DR. JOHN THOMAS HARRIS M.D. (NPI 1710189709)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710189709 NPI number — DR. JOHN THOMAS HARRIS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARRIS
Provider First Name:
JOHN
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710189709
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3089
Provider Second Line Business Mailing Address:
CENTER FOR MENTAL HEALTH
Provider Business Mailing Address City Name:
GREAT FALLS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59403-3089
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-761-2100
Provider Business Mailing Address Fax Number:
406-761-2107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 JACKSON ST
Provider Second Line Business Practice Location Address:
CENTER FOR MENTAL HEALTH
Provider Business Practice Location Address City Name:
HELENA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59601-3428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-443-7151
Provider Business Practice Location Address Fax Number:
406-443-3420
Provider Enumeration Date:
06/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  11371 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0000099066 . This is a "BLUE CROSS-SHIELD OF MONT" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: P00692143 C01340 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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