Basic Information
| Provider Information | |||||||||
| NPI: | 1285874834 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARMAN | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | KENT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 N LEE AVE | ||||||||
| Address2: | ROOM 4404 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731021036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052726406 | ||||||||
| FaxNumber: | 4052726075 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 N LEE AVE | ||||||||
| Address2: | ROOM 4404 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731021036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052726406 | ||||||||
| FaxNumber: | 4052726075 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2009 | ||||||||
| LastUpdateDate: | 05/08/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0102X | ME103630 | FL | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0102X | 27713 | OK | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
ID Information
| ID | Type | State | Issuer | Description | 1285874834 | 01 | FL | TRICARE | OTHER | 149N4 | 01 | FL | BLUE CROSS BLUE SHIELD OF FLORIDA | OTHER | 002634100 | 05 | FL | MEDICAID |