Provider Demographics
NPI:1457368607
Name:HARRIS, PATRICE ANNETTE (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICE
Middle Name:ANNETTE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1397 WOOD POND CV
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-1231
Mailing Address - Country:US
Mailing Address - Phone:404-298-7342
Mailing Address - Fax:
Practice Address - Street 1:1299 METROPOLITAN PKWY SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-4449
Practice Address - Country:US
Practice Address - Phone:404-762-4111
Practice Address - Fax:404-762-4109
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0387942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry