Organization
JEFFREY L. HARRIS, MD, PC
Active
Other names
Wayne Obstetrics and Gynecology
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTONIA BROOKE HARRIS CSW (EXECUTIVE OFFICE MANAGER)
(912) 530-7301
Entity
Organization
Contact information
Practice address
371 PEACHTREE ST, JESUP, GA 31545-0245
(912) 530-7301
(912) 530-7302
Mailing address
PO BOX 604, JESUP, GA 31598-0604
(912) 530-7301
(912) 530-7302
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
024255
GA
207V00000X
Obstetrics & Gynecology Physician
Primary
024255
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000815889C
—
GA
05
—
301000006A
—
GA
Enumeration date
04/05/2006
Last updated
11/01/2011
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