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NPI Code Detail

MEDICARE: DR. JIMMIE L HARRIS DO

MEDICARE: DR. JIMMIE L HARRIS DO
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
12084P0800XPsychiatry Physician5101010703MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578539128
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JIMMIE L HARRIS DO
Provider Business Mailing Address
First Line : 812 E JOLLY RD
Second Line : SUITE 210
City : LANSING
State : MI
Zip : 48910-6818
Country : US
Telephone Number : 517-346-8200
Fax Number :
Provider Business Practice Location Address
First Line : 812 E JOLLY RD
Second Line : SUITE 110
City : LANSING
State : MI
Zip : 48910-6818
Country : US
Telephone Number : 517-346-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2006
Last Update Date : 06/15/2015

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Directions to “ DR. JIMMIE L HARRIS DO” Practice Location

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