Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. CHARLES RUSSELL HARRIS JR., M.D.
ActiveDR. CHARLES RUSSELL HARRIS JR., M.D. is a Dermatology healthcare provider located in FORSYTH, Georgia. NPI 1073590410 is currently active in the NPPES registry. Verify at CMS.
Dermatology · FORSYTH, GA
Registration Details
- NPI Number
- 1073590410
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 28, 2005 (20.637317414133 yrs)
- Last Updated
- Apr 23, 2015
- Licenses
-
019692 (GA)019692 (GA)019692 (GA)019692 (GA)019692 (GA)
Practice Information
- Address
-
101 MARTIN LUTHER KING JR DRFORSYTH, GA, 310291698Browse GA providers · Browse ZIP 31029
- Phone
- 4789945281
- Fax
- 4789949781
- Primary Specialty
-
Dermatology
207N00000X
- Additional Specialty
- Dermatology
- Additional Specialty
- 207NP0225X
- Additional Specialty
- General Practice
- Additional Specialty
- Dermatopathology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.