Individual
MR. RYAN KEITH HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
849 S THREE NOTCH ST, ANDALUSIA, AL 36420-5325
(334) 222-8466
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.1574
AL
363AM0700X
Medical Physician Assistant
PA9112683
FL
Other
Enumeration date
10/30/2018
Last updated
03/13/2020
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