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General NPI Number Information
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NPI Number | 1275710204
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Entity Type | Individual
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Provider Name | WILLIAM HENRY HARRISON III MD
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Gender | Male
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 01/04/2010
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Provider Practice Location Address
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Address Line | 319 WEST CHURCH STREET
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City | LAWRENCEVILLE
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State | VA
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Zip | 23868
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Country | US
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Telephone | 434-848-0072
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Fax |
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Provider Business Mailing Address
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Address Line | 319 W CHURCH ST
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City | LAWRENCEVILLE
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State | VA
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Zip | 23868-1706
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Country | US
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Telephone | 434-848-0072
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Fax | 434-848-0141
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101038490
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License Number State | VA
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