Healthcare Provider Details
I. General information
NPI: 1235073743
Provider Name (Legal Business Name): JOHN J HARRIS MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3803 WRIGHTSVILLE AVE STE 7
WILMINGTON NC
28403-6232
US
IV. Provider business mailing address
3803 WRIGHTSVILLE AVE STE 7
WILMINGTON NC
28403-6232
US
V. Phone/Fax
- Phone: 910-617-6413
- Fax:
- Phone: 910-617-6413
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083A0300X |
| Taxonomy | Addiction Medicine (Preventive Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LA0401X |
| Taxonomy | Addiction Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
J
HARRIS
JR.
Title or Position: SOLE OWNER
Credential: MD
Phone: 910-547-4241