Organization
CHARLES HARRIS PHD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES EUGENE HARRIS PHD (CHIEF OFFICER)
228875764827
Entity
Organization
Contact information
Practice address
1217 NELSON DR, OCEAN SPRINGS, MS 39564-3032
(228) 875-7648
Mailing address
1217 NELSON DR, OCEAN SPRINGS, MS 39564-3032
(228) 875-7648
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
36-620
MS
314000000X
Skilled Nursing Facility
Primary
36-620
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36-620
PSYCHOLOGIST LICENSE NUMBER
MS
01
—
680000286
MEDICARE IDENTIFICAQTION NUMBER
MS
Enumeration date
01/06/2015
Last updated
01/06/2015
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