Dr Charles Russell Harris Jr, MD is a medicare enrolled "Dermatology" physician in Forsyth, Georgia. He went to Vanderbilt University School Of Medicine and graduated in 1975 and has 49 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Georgia Dermatology And Skin Cancer Center, Llc and his current practice location is
101 Martin Luther King Jr Dr, Forsyth, Georgia. You can reach out to his office (for appointments etc.) via phone at
(478) 994-5281.
Dr Charles Russell Harris Jr is licensed to practice in Georgia (license number 019692) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1073590410.
Physician's Profile
| Full Name | Dr Charles Russell Harris Jr |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 49 Years |
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| Location | 101 Martin Luther King Jr Dr, Forsyth, Georgia |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Charles Russell Harris Jr attended and graduated from Vanderbilt University School Of Medicine in 1975
NPI Data:
- NPI Number: 1073590410
- Provider Enumeration Date: 12/28/2005
- Last Update Date: 04/23/2015
Medicare PECOS Information:
- PECOS PAC ID: 5294799227
- Enrollment ID: I20041119000307
Medical Identifiers
Medical identifiers for Dr Charles Russell Harris Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073590410 | NPI | - | NPPES |
| 003136057 | Medicaid | GA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207NS0135X | Dermatology - Procedural Dermatology | 019692 (Georgia) | Secondary |
| 207N00000X | Dermatology | 019692 (Georgia) | Primary |
| 207NP0225X | Dermatology - Pediatric Dermatology | 019692 (Georgia) | Secondary |
| 208D00000X | General Practice | 019692 (Georgia) | Secondary |
| 207ND0900X | Dermatology - Dermatopathology | 019692 (Georgia) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Georgia Dermatology And Skin Cancer Center, Llc | 7113980855 | 48 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Charles Russell Harris Jr allows following entities to bill medicare on his behalf.
| Entity Name | Metroderm, P.c. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205833894
PECOS PAC ID: 8729076443
Enrollment ID: O20040503000850 |
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| Entity Name | Georgia Dermatology & Skin Cancer Center, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063460459
PECOS PAC ID: 7113980855
Enrollment ID: O20041104000512 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Charles Russell Harris Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Charles Russell Harris Jr, MD
2400 Bellevue Rd, Suite 21-a,
Dublin, GA 31021-2885
Ph: (478) 275-7202 | Dr Charles Russell Harris Jr, MD
101 Martin Luther King Jr Dr,
Forsyth, GA 31029-1698
Ph: (478) 994-5281 |
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