Provider Demographics
NPI:1063615714
Name:HARRIS, ABBY LEA (MD)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:LEA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-5500
Mailing Address - Country:US
Mailing Address - Phone:334-595-8610
Mailing Address - Fax:334-595-8611
Practice Address - Street 1:1840 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-5500
Practice Address - Country:US
Practice Address - Phone:334-595-8610
Practice Address - Fax:334-595-8611
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01066398A207Q00000X
ALMD.41362207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL41362OtherAL STATE CONTROLLED SUBSTANCE CERTIFICATION