Provider Demographics
NPI:1144258088
Name:HARPER, EUGENE THOMAS (DPM)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:THOMAS
Last Name:HARPER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13507
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48501-3507
Mailing Address - Country:US
Mailing Address - Phone:810-238-3338
Mailing Address - Fax:810-238-9577
Practice Address - Street 1:3725 S SAGINAW ST
Practice Address - Street 2:SUITE 110
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-4321
Practice Address - Country:US
Practice Address - Phone:810-238-3338
Practice Address - Fax:810-238-9577
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI59010000989213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4151747-13Medicaid
MI5409890001OtherDME POS NUMBER
MI480034386OtherPALMETTO GBA
MI4852550010OtherBLUE CROSS
MI5409890001OtherDME POS NUMBER
MI4151747-13Medicaid