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General NPI Number Information
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NPI Number | 1215917281
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Entity Type | Individual
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Provider Name | CHARLES R HARRIS PA
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Gender | Male
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6000 W HIGHWAY 98 NAVAL HOSPITAL
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City | PENSACOLA
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State | FL
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Zip | 32512-0001
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Country | US
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Telephone | 850-505-6802
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Fax |
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Provider Business Mailing Address
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Address Line | 341 CAMBORNE PL
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City | PENSACOLA
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State | FL
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Zip | 32506-4921
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Country | US
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Telephone | 850-455-0466
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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