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General NPI Number Information
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NPI Number | 1730404377
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Entity Type | Individual
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Provider Name | JEWEL ARRIE HARRIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 01/22/2019
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Provider Practice Location Address
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Address Line | 1169 JEFFERSON AVE
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City | MEMPHIS
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State | TN
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Zip | 38104-7217
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 12900 PARK PLAZA DR STE 150
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City | CERRITOS
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State | CA
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Zip | 90703-9329
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Country | US
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Telephone | 562-977-4639
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Fax | 562-741-4479
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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 | 50219
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License Number State | TN
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