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NPI Code Detail

MEDICARE: JOEY LEE HARRIS OD

MEDICARE: JOEY LEE HARRIS OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist1795NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10929WOTHERNCBCBS
256162OTHERNCMEDCOST
324120OTHERNCCIGNA OPTICARE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457486854
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOEY LEE HARRIS OD
Provider Business Mailing Address
First Line : 2170 MIDLAND RD
Second Line :
City : SOUTHERN PINES
State : NC
Zip : 28387-2999
Country : US
Telephone Number : 910-295-2100
Fax Number : 910-295-5339
Provider Business Practice Location Address
First Line : 2170 MIDLAND RD
Second Line :
City : SOUTHERN PINES
State : NC
Zip : 28387-2999
Country : US
Telephone Number : 910-295-2100
Fax Number : 910-295-5339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 12/20/2023

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