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NPI Code Detail

MEDICARE: WESLEY W HARRIS JR. MD

MEDICARE: WESLEY W HARRIS JR. MD
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
1207Q00000XFamily Medicine Physician056840GA

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 : 1588694988
Entity Type Code : Individual
Provider Name (Legal Business Name) : WESLEY W HARRIS JR. MD
Provider Business Mailing Address
First Line : 103 WILLOW TREE DR
Second Line :
City : MERIDIANVILLE
State : AL
Zip : 35759-5100
Country : US
Telephone Number : 706-331-0365
Fax Number : 301-235-1522
Provider Business Practice Location Address
First Line : 101 SIVLEY RD SW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35801-4470
Country : US
Telephone Number : 256-265-9889
Fax Number : 256-265-9910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 07/01/2020

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