Individual
DR. CAROL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 703-4362
(601) 703-1320
Mailing address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 703-4362
(601) 703-1320
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
336060187
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
01070601A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
336060187
IL
208VP0014X
Interventional Pain Medicine Physician
Primary
01070601A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201067100
MEDICAID
IN
Enumeration date
05/04/2006
Last updated
11/30/2015
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