Healthcare Provider Details

I. General information

NPI: 1497791628
Provider Name (Legal Business Name): CHRISTOPHER BARRY HARMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 STONEGATE DR STE 130
VESTAVIA HLS AL
35242
US

IV. Provider business mailing address

1940 STONEGATE DR STE 130
VESTAVIA HLS AL
35242-2541
US

V. Phone/Fax

Practice location:
  • Phone: 205-977-9876
  • Fax: 205-977-9976
Mailing address:
  • Phone: 205-977-9876
  • Fax: 205-977-9976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number20579
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number20579
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number20579
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: