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NPI Code Detail

MEDICARE: JUSTIN LADELL HARRISON PA

MEDICARE: JUSTIN LADELL HARRISON PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1366452609
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN LADELL HARRISON PA
Provider Business Mailing Address
First Line : 1633 COTTONWOOD ST
Second Line :
City : ABILENE
State : TX
Zip : 79601-3033
Country : US
Telephone Number : 325-672-4372
Fax Number : 325-673-0856
Provider Business Practice Location Address
First Line : 1633 COTTONWOOD ST
Second Line :
City : ABILENE
State : TX
Zip : 79601-3033
Country : US
Telephone Number : 325-672-4372
Fax Number : 325-673-0856
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 07/20/2021

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Directions to “ JUSTIN LADELL HARRISON PA” Practice Location

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