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NPI Code Detail

MEDICARE: SAMUEL EMERSON HARRIS PA

MEDICARE: SAMUEL EMERSON HARRIS PA
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1477417913
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL EMERSON HARRIS PA
Provider Business Mailing Address
First Line : 22104 HILBUN DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35242-7088
Country : US
Telephone Number : 205-570-8250
Fax Number :
Provider Business Practice Location Address
First Line : 3690 GRANDVIEW PKWY
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35243-3326
Country : US
Telephone Number : 205-971-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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Directions to “ SAMUEL EMERSON HARRIS PA” Practice Location

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