| Jeffrey L. Harris, Md, Pc | |
|
371 Peachtree St Jesup GA 31545-0245 | |
| (912) 530-7301 | |
| (912) 530-7302 |
| Full Name | Jeffrey L. Harris, Md, Pc |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 371 Peachtree St, Jesup, Georgia |
| Authorized Official Name and Position | Antonia Brooke Harris (EXECUTIVE OFFICE MANAGER) |
| Authorized Official Contact | 9125307301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey L. Harris, Md, Pc Po Box 604 Jesup GA 31598-0604 Ph: (912) 530-7301 | Jeffrey L. Harris, Md, Pc 371 Peachtree St Jesup GA 31545-0245 Ph: (912) 530-7301 |
| NPI Number | 1285696112 |
|---|---|
| Provider Enumeration Date | 04/05/2006 |
| Last Update Date | 11/01/2011 |
| Medicare PECOS PAC ID | 1254361397 |
|---|---|
| Medicare Enrollment ID | O20050817001046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285696112 | NPI | - | NPPES |
| 301000006A | Medicaid | GA | |
| 000815889C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 024255 (Georgia) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 024255 (Georgia) | Primary |
| Provider Name | Jeffrey Harris |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801850094 PECOS PAC ID: 3173599164 Enrollment ID: I20040910000099 |
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