Organization
JACQUELINE HARRIS, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE HARRIS MD (OWNER)
(843) 422-4413
Entity
Organization
Contact information
Practice address
107 SEAGRASS STATION RD, BLUFFTON, SC 29910-3110
(836) 843-8200
(843) 836-8595
Mailing address
PO BOX 14624, SAVANNAH, GA 31416-1624
(843) 422-4413
(866) 848-1697
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52695
MEDICAL LICENSE
SC
Enumeration date
06/25/2018
Last updated
06/25/2018
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