MEDICARE: HARVEY A HARRIS

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
1	207R00000X	Internal Medicine Physician	037825	GA

General Provider Information

NPI Number	:	1609877315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARVEY A HARRIS

Provider Business Mailing Address
First Line	:	106 ENTERPRISE COURT
Second Line	:	SUITE C
City	:	COLUMBUS
State	:	GA
Zip	:	31904
Country	:	US
Telephone Number	:	706-321-2585
Fax Number	:	706-321-2586

Provider Business Practice Location Address
First Line	:	1900 10TH AVE
Second Line	:	211
City	:	COLUMBUS
State	:	GA
Zip	:	31901-3600
Country	:	US
Telephone Number	:	706-321-2585
Fax Number	:	706-321-2586

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	02/27/2012

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Directions to “ HARVEY A HARRIS ” Practice Location

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