Organization
THERON HARRISON, D.O., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THERON GERARD HARRISON D.O. (CEO/OWNER)
(478) 453-3532
Entity
Organization
Contact information
Practice address
108 FIELDSTONE DR, MILLEDGEVILLE, GA 31061-7110
(478) 453-3532
(478) 453-4496
Mailing address
PO BOX 1329, MILLEDGEVILLE, GA 31059-1329
(478) 453-3532
(478) 453-4496
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
051143
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00953037A
—
GA
Enumeration date
12/12/2007
Last updated
12/12/2007
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