Provider Demographics
NPI:1215935580
Name:HARROLD, JOAN KAY (MD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:KAY
Last Name:HARROLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 HERR AVE
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17551-1528
Mailing Address - Country:US
Mailing Address - Phone:717-295-3900
Mailing Address - Fax:717-391-9582
Practice Address - Street 1:685 GOOD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2426
Practice Address - Country:US
Practice Address - Phone:717-295-3900
Practice Address - Fax:717-391-9582
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-064368-L207R00000X
VA0101054552207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G18073Medicare UPIN