Doctor Name: | DR. SARA HARRIS |
NPI Number: | 1902196553 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 72284 |
Business Practice Address: | 3815 Harrison Rd Loganville, GA - 300522462 |
Business Phone Number: | 7704666112 |
Business Fax Number: | |
Mailing Address: | 3815 Harrison Rd, LOGANVILLE |
State: | GA |
Postal Code: | 300522462 |
Phone Number: | 7704666112 |
Fax Number: | |
NPI Enumeration Date: | 04/17/2011 |
NPI Last Update Date: | 08/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 72284 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |