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Individual

JEFFREY G HARRISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
201 N BREAZEALE AVE, MOUNT OLIVE, NC 28365-1603
(919) 658-4954
(919) 581-4966
Mailing address
201 N BREAZEALE AVE, MOUNT OLIVE, NC 28365-1603
(919) 658-4954
(919) 581-4966

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
102551
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MEDICAL LICENSE
102680
NC
Enumeration date
10/18/2005
Last updated
02/20/2014
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