Healthcare Provider Details

I. General information

NPI: 1699946996
Provider Name (Legal Business Name): JOHN JOEL HARRIS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2008
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

Practice location:
  • Phone: 910-617-6413
  • Fax:
Mailing address:
  • Phone: 910-617-6413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number32114
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number32114
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number32114
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: