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Physician Compare National (NPI:1295785103)

HEALTHCARE PROVIDER: ADAM W HARRIS MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1295785103
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 8426087180
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20050812000050
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name HARRIS
Individual professional last name
Provider First Name ADAM
Individual professional first name
Provider Middle Name W
Individual professional middle name
Provider Name Suffix Text SR.
The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender M
The provider's gender if the provider is a person.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Individual professional's medical school
Graduation Year 1997
Individual professional's medical school graduation year
Primary Specialty PSYCHIATRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2479 HWY 17 S
Group Practice or individual's line 1 address
Line 2 Street Address SUITE B
Group Practice or individual's line 2 address
City RICHMOND HILL
Group Practice or individual's city
State GA
Group Practice or individual's state
Zip Code 31324
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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