Harris, Glenn A
Harris, Glenn A is an sole proprietor health care provider with primary practice located at 150 S Ingleside St Ste 4 , Fairhope AL 36532-1804. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Other Service Providers / Specialist is his primary health care specialty. Harris, Glenn A can be contacted via phone (251) 990-1920.Contact Information
Primary practice address
150 S Ingleside St Ste 4
Fairhope AL 36532-1804
Phone: (251) 990-1920
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | A68303 | California |
| Other Service Providers / Specialist | 174400000X | 2003029891 | Missouri |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 162439 | North Carolina |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 162439 | North Carolina |
| Other Service Providers / Specialist | 174400000X | 200000225 | North Carolina |
Profile Details
| NPI number | 1659478014 |
|---|---|
| LBN Legal business name | Harris, Glenn A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Mar 23rd, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659478014 | NPPES |
| North Carolina | MEDICAID | 5900317 |
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