Individual
JACK A HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
274 BIG A ROAD, TOCCOA, GA 30577-6002
(706) 886-0421
(706) 297-7617
Mailing address
274 BIG A ROAD, TOCCOA, GA 30577-6002
(706) 886-0421
(706) 297-7617
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
29879
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
335410959A
—
GA
Enumeration date
08/24/2005
Last updated
06/13/2013
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