Individual
JEREMY REED HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3409 GREEN OAKS LN, MIDDLEBURG, FL 32068-3421
(757) 392-4087
Mailing address
3409 GREEN OAKS LN, MIDDLEBURG, FL 32068-3421
(757) 392-4087
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
H620436762480
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H620436762480
—
FL
Enumeration date
05/02/2021
Last updated
05/02/2021
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