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General NPI Number Information
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NPI Number | 1982750048
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Entity Type | Organization
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Legal Business Name | HARPER & ASSOCIATES FAMILY MEDICINE, P.C.
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 5910 HILLANDALE DRIVE SUITE 301
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City | LITHONIA
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State | GA
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Zip | 30058
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Country | US
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Telephone | 678-418-2120
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Fax | 678-418-2936
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Provider Business Mailing Address
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Address Line | P.O. BOX 856
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City | LITHONIA
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State | GA
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Zip | 30058
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Country | US
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Telephone | 678-418-2120
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Fax | 678-418-2936
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH HARPER
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Credential | MD
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Telephone | 678-418-2120
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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 | 055830
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 004798
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 035182
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License Number State | GA
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