| Theron Harrison, D.o., Pc | |
|
108 Fieldstone Dr Milledgeville GA 31061-7110 | |
| (478) 453-3532 | |
| (478) 453-4496 |
| Full Name | Theron Harrison, D.o., Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 108 Fieldstone Dr, Milledgeville, Georgia |
| Authorized Official Name and Position | Theron Gerard Harrison (CEO/OWNER) |
| Authorized Official Contact | 4784533532 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theron Harrison, D.o., Pc Po Box 1329 Milledgeville GA 31059-1329 Ph: (478) 453-3532 | Theron Harrison, D.o., Pc 108 Fieldstone Dr Milledgeville GA 31061-7110 Ph: (478) 453-3532 |
| NPI Number | 1518140524 |
|---|---|
| Provider Enumeration Date | 12/12/2007 |
| Last Update Date | 12/12/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518140524 | NPI | - | NPPES |
| 00953037A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 051143 (Georgia) | Primary |
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