Individual
KEITH R. HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 MARKET PLACE BLVD STE 300, CARTERSVILLE, GA 30121-8717
(470) 490-9600
(470) 447-1815
Mailing address
103 JOHN MADDOX DR NW, ROME, GA 30165-1419
(706) 235-7711
(706) 235-9944
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
050930
GA
207N00000X
Dermatology Physician
Primary
050930
GA
Other
Enumeration date
08/22/2005
Last updated
10/08/2020
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