Individual
BLAIR E HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA/AA
Contact information
Practice address
380 HOSPITAL DRIVE, STE 410, MACON, GA 31217
(478) 746-5644
(478) 745-4849
Mailing address
PO BOX 2564, MACON, GA 31203
(478) 746-5644
(478) 745-4849
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
002992
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100001226A
—
GA
05
—
100001226B
—
GA
05
—
100001226C
—
GA
05
—
100001226D
—
GA
01
—
326185
WELLCARE
GA
01
—
970007565
RAILROAD MEDICARE
GA
Enumeration date
08/04/2006
Last updated
06/04/2013
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