Provider Demographics
NPI:1104969898
Name:NORTHSHORE FAMILY MEDICINE, P.C.
Entity type:Organization
Organization Name:NORTHSHORE FAMILY MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DWIGHT
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-546-5232
Mailing Address - Street 1:303 BAY ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5265
Mailing Address - Country:US
Mailing Address - Phone:256-546-5232
Mailing Address - Fax:256-546-5208
Practice Address - Street 1:303 BAY ST
Practice Address - Street 2:SUITE 203
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5265
Practice Address - Country:US
Practice Address - Phone:256-546-5232
Practice Address - Fax:256-546-5208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17428207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty