Doctor Name: | ELICIA LAUREN HARRIS |
NPI Number: | 1447488952 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 01068940A |
Business Practice Address: | 6418 E State Blvd Fort Wayne, IN - 468157025 |
Business Phone Number: | 2604324400 |
Business Fax Number: | 2609696898 |
Mailing Address: | 2518 E Dupont Rd, FORT WAYNE |
State: | IN |
Postal Code: | 468251675 |
Phone Number: | 2604324400 |
Fax Number: | 2609696898 |
NPI Enumeration Date: | 06/24/2009 |
NPI Last Update Date: | 03/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 01068940A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |