Individual
DR. KEVIN RUSSELL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2620 CENTRON DR SW, DECATUR, AL 35603-2500
(256) 350-6655
(256) 350-2548
Mailing address
1641 BYRD RD, HARTSELLE, AL 35640-5907
(256) 751-1125
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S813 TA107
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000-79209
—
AL
Enumeration date
02/02/2007
Last updated
07/08/2007
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