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Individual

DR. GARY B HARRELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1559 PROFESSIONAL PKWY, AUBURN, AL 36830-2858
(334) 826-1121
(334) 826-1149
Mailing address
1559 PROFESSIONAL PKWY, AUBURN, AL 36830-2858
(334) 826-1121
(334) 826-1149

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11448
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
510G700530
MEDICARE PTAN
AL
01
51503715
BLUE CROSS
AL
05
529913570
AL
Enumeration date
01/23/2006
Last updated
05/17/2012
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