Organization
RUSSELL HARRIS, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL HARRIS JR. MD (PHYSICIAN/OWNER)
(404) 851-9480
Entity
Organization
Contact information
Practice address
5669 PEACHTREE DUNWOODY RD NE, SUITE 350, ATLANTA, GA 30342-1786
(404) 851-9480
(404) 236-0075
Mailing address
5669 PEACHTREE DUNWOODY RD NE, SUITE 350, ATLANTA, GA 30342-1786
(404) 851-9480
(404) 236-0075
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
019692
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215714
BLUE CROSS BLUE SHIELD
GA
Enumeration date
10/13/2006
Last updated
11/08/2007
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