Healthcare Provider Details

I. General information

NPI: 1376619304
Provider Name (Legal Business Name): DONALD WILSON HARPER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3486 PEACH ORCHARD RD STE 200
AUGUSTA GA
30906-5215
US

IV. Provider business mailing address

329 PUMP HOUSE RD
EVANS GA
30809-5180
US

V. Phone/Fax

Practice location:
  • Phone: 706-828-8000
  • Fax:
Mailing address:
  • Phone: 706-833-5635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3958
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: