Individual
MR. JOHN MICHAEL HARKLESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1040 HOLSTON RD, WYTHEVILLE, VA 24382-4107
(276) 227-0200
(276) 227-0202
Mailing address
340 PEPPERS FERRY RD, SUITE C, WYTHEVILLE, VA 24382-2056
(276) 227-0200
(276) 227-0202
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102202346
VA
207Q00000X
Family Medicine Physician
OS-014404
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083870455
—
VA
Enumeration date
08/05/2008
Last updated
03/30/2021
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