Individual
PORTIA M HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
104 MILLSAPS DR, HATTIESBURG, MS 39402-1328
(601) 288-7500
(601) 268-5179
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 288-7500
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
20212
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030152720
—
MS
05
—
1058289
—
LA
01
—
9730184
AETNA
MS
Enumeration date
07/30/2007
Last updated
07/22/2020
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