Individual
DR. BERNARD GAYLE HARRELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1080 HIGHWAY 35 S, FOREST, MS 39074-9423
(601) 469-3555
(601) 469-3584
Mailing address
PO BOX 5183, MERIDIAN, MS 39302-5183
(601) 703-9506
(601) 703-3264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10830
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00013342
—
MS
01
—
010013307
RAILROAD MEDICARE
—
Enumeration date
11/16/2005
Last updated
07/08/2007
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