Organization
SURGICAL ONCOLOGY & GENERAL SUGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BRUCE HARRIS M.D. (OWNER)
(251) 368-9826
Entity
Organization
Contact information
Practice address
406 MEDICAL PARK DR, ATMORE, AL 36502-3016
(251) 368-9826
(251) 368-3917
Mailing address
PO BOX 30195, PENSACOLA, FL 32503-1195
(251) 368-9826
(251) 368-3917
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9132
AL
208600000X
Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000080702
MEDICARE
AL
05
—
000080702
—
AL
01
—
010024215
RR MEDICARE
AL
01
—
51080702
BCBS
AL
01
—
529301280
MEDICAID GROUP #
AL
Enumeration date
04/09/2007
Last updated
02/09/2023
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