Provider Demographics
NPI:1992713408
Name:HARRIS, PATRICK SCOTT (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:SCOTT
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1215 SEVENTH STREET, SE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601
Mailing Address - Country:US
Mailing Address - Phone:256-350-1862
Mailing Address - Fax:256-350-9812
Practice Address - Street 1:1215 SEVENTH STREET, SE
Practice Address - Street 2:SUITE 120
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601
Practice Address - Country:US
Practice Address - Phone:256-350-1862
Practice Address - Fax:256-350-9812
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00016614207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009966530Medicaid
AL51504434OtherBCBS
AL009966530Medicaid
ALF30493Medicare UPIN