Healthcare Provider Details

I. General information

NPI: 1992729156
Provider Name (Legal Business Name): JOHN DAVID HARRINGTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 LIFE STYLE LN
WILDWOOD GA
30757-4174
US

IV. Provider business mailing address

435 LIFE STYLE LN
WILDWOOD GA
30757-4174
US

V. Phone/Fax

Practice location:
  • Phone: 417-321-0064
  • Fax:
Mailing address:
  • Phone: 417-321-0064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number112005
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number75220
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: