Individual
DR. KIRK RANDALL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1302 BROWN ST, WASHINGTON, NC 27889-4672
(252) 946-7257
(252) 946-9497
Mailing address
1950 OLD GALLOWS RD, VIENNA, VA 22182-3990
(703) 847-8899
(703) 991-0514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1419
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0139010001
DMERC GROUP #
NC
01
—
0913E
BCBS PROV #
NC
01
—
09691
BCBS GROUP #
NC
01
—
246648E
MEDICARE GROUP #
NC
01
—
410018240
RAILROAD MCARE PROVIDER #
NC
05
—
890913E
—
NC
01
—
8909691
MEDICAID GROUP #
NC
01
—
DB8258
RAILROAD MEDICARE GRP #
NC
Enumeration date
07/28/2005
Last updated
04/07/2022
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