Basic Information
Provider Information
NPI: 1487617080
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARPER
FirstName: DOUGLAS
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 680
Address2:  
City: SHAWNEE MISSION
State: KS
PostalCode: 662010680
CountryCode: US
TelephoneNumber: 9134694244
FaxNumber: 9134691939
Practice Location
Address1: 1823 COLLEGE AVE
Address2:  
City: MANHATTAN
State: KS
PostalCode: 665023381
CountryCode: US
TelephoneNumber: 7857763322
FaxNumber: 7855654754
Other Information
ProviderEnumerationDate: 04/07/2006
LastUpdateDate: 03/05/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X426277KSY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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