Individual
MR. BENJAMIN L HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
458 NEWBERRY RD, WHIGHAM, GA 39897-2924
(404) 537-2221
Mailing address
458 NEWBERRY RD, WHIGHAM, GA 39897-2924
(404) 537-2221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
050525
GA
207Q00000X
Family Medicine Physician
Primary
101257079
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000922215F
—
GA
05
—
00922215E
—
GA
Enumeration date
09/23/2005
Last updated
12/16/2015
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