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General NPI Number Information
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NPI Number | 1063499069
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Entity Type | Organization
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Legal Business Name | CHARLOTTE J. HARRIS, MD, PSC
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 07/29/2010
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Provider Practice Location Address
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Address Line | 991 MEDICAL PARK DR SUITE 300
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City | MAYSVILLE
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State | KY
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Zip | 41056-8764
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Country | US
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Telephone | 606-759-9729
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Fax | 606-759-0602
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Provider Business Mailing Address
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Address Line | 991 MEDICAL PARK DR SUITE 300
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City | MAYSVILLE
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State | KY
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Zip | 41056-8764
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Country | US
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Telephone | 606-759-9729
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Fax | 606-759-0602
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLOTTE J. HARRIS
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Credential | MD
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Telephone | 606-759-9729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 26277
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License Number State | KY
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