Provider Demographics
NPI:1154427466
Name:HARPER, MARRON C (PA)
Entity type:Individual
Prefix:MRS
First Name:MARRON
Middle Name:C
Last Name:HARPER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 720
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824
Mailing Address - Country:US
Mailing Address - Phone:706-597-9700
Mailing Address - Fax:706-597-0790
Practice Address - Street 1:510 MT PLEASANT RD
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824
Practice Address - Country:US
Practice Address - Phone:706-597-9700
Practice Address - Fax:706-597-0790
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4082207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P93610Medicare UPIN
97WCGSXMedicare ID - Type Unspecified