=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235073743
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOHN J HARRIS MD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2026
-----------------------------------------------------
Last Update Date | 04/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3803 WRIGHTSVILLE AVE STE 7
-----------------------------------------------------
City | WILMINGTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28403-6232
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-617-6413
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3803 WRIGHTSVILLE AVE STE 7
-----------------------------------------------------
City | WILMINGTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28403-6232
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-617-6413
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE OWNER
-----------------------------------------------------
Name | DR. JOHN J HARRIS JR.
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 910-547-4241
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2083A0300X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207LA0401X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------