Individual
DR. JERRY WAYNE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5323 FOX COVE LN, U, GREENSBORO, NC 27407-5961
(336) 638-3700
Mailing address
PO BOX 39721, GREENSBORO, NC 27438-9721
(336) 638-3700
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
326
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890808E
—
NC
Enumeration date
06/21/2006
Last updated
07/08/2007
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