Provider Demographics
NPI:1063622280
Name:HARRISON, DANIEL KEITH (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:KEITH
Last Name:HARRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 MONTCLAIR RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1211
Mailing Address - Country:US
Mailing Address - Phone:205-591-7999
Mailing Address - Fax:205-591-5051
Practice Address - Street 1:924 MONTCLAIR RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1211
Practice Address - Country:US
Practice Address - Phone:205-591-7999
Practice Address - Fax:205-591-5051
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26380207ZN0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology