Healthcare Provider Details

I. General information

NPI: 1225389976
Provider Name (Legal Business Name): LAURA T HARRIS P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 S UNIVERSITY BLVD
MOBILE AL
36608-3271
US

IV. Provider business mailing address

PO BOX 21595
BELFAST ME
04915-4112
US

V. Phone/Fax

Practice location:
  • Phone: 251-660-5797
  • Fax: 251-660-5142
Mailing address:
  • Phone: 251-318-2678
  • Fax: 251-405-9900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA854
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: