Provider Demographics
NPI:1194941229
Name:HARRELL, ANDREW JACKSON IV (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JACKSON
Last Name:HARRELL
Suffix:IV
Gender:
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:800 BRADBURY DR SE STE 116
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF EMERGENCY MEDICINE
Practice Address - Street 2:MSC10 5560, 1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-5062
Practice Address - Fax:505-272-6503
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMRS20070296207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine