Individual
KENNETH WESLEY HARPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
PO BOX 360365, DECATUR, GA 30036-0365
(404) 433-1819
(678) 418-2936
Mailing address
PO BOX 360365, DECATUR, GA 30036-0365
(404) 433-1819
(678) 418-2936
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
035182
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00794912C
—
GA
01
—
035182
STATE LICENSE
GA
Enumeration date
11/28/2006
Last updated
07/19/2024
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