Provider Demographics
NPI:1699772194
Name:HARPER, STEPHEN KENT (CPO)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:KENT
Last Name:HARPER
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 CREEK RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7456
Mailing Address - Country:US
Mailing Address - Phone:919-933-6520
Mailing Address - Fax:919-806-3430
Practice Address - Street 1:6208 FAYETTEVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6286
Practice Address - Country:US
Practice Address - Phone:919-806-3910
Practice Address - Fax:919-806-3430
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCPO01322222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795085Medicaid
NC4552310001Medicare ID - Type Unspecified