Provider Demographics
NPI:1992925978
Name:HARRIS FAMILY PRACTICE PLLC
Entity type:Organization
Organization Name:HARRIS FAMILY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-276-6767
Mailing Address - Street 1:700 PROGRESS PL # A
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5545
Mailing Address - Country:US
Mailing Address - Phone:910-276-6767
Mailing Address - Fax:910-276-7877
Practice Address - Street 1:700 PROGRESS PL # A
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5545
Practice Address - Country:US
Practice Address - Phone:910-276-6767
Practice Address - Fax:910-276-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty