Individual
DR. LESLIE HARRIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2055 E SOUTH BLVD, SUITE 202, MONTGOMERY, AL 36116-2002
(334) 747-7575
(334) 747-7590
Mailing address
301 BROWN SPRINGS RD, MONTGOMERY, AL 36117-7005
(334) 747-4159
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00023925
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051504697
BLUE CROSS BLUE SHIELD
AL
05
—
051504697
—
AL
01
—
636005396005
HUMANA GOLD CHOICE MEDICARE
—
01
—
7200716
AETNA
—
Enumeration date
03/24/2006
Last updated
01/11/2023
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