Physician Compare National (NPI:1831214287)

HEALTHCARE PROVIDER: CAROLYN S HARRIS DO

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

Individual Professional Information
NPI	1831214287
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385716919
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101025000681
	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	CAROLYN
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF PIKEVILLE, KENTUCKY COLLEGE OF OSTEOPATHIC MED
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	NUCLEAR MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	NUCLEAR MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	138 CAMPBELLSVILLE BYP
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 5
	Group Practice or individual's line 2 address
City	CAMPBELLSVILLE
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	427188843
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	180087
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TAYLOR REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y