Basic Information
| Provider Information | |||||||||
| NPI: | 1164424123 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARRISON | ||||||||
| FirstName: | JOAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1070 | ||||||||
| Address2: | |||||||||
| City: | FALL RIVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027221070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086763292 | ||||||||
| FaxNumber: | 5086727181 | ||||||||
| Practice Location | |||||||||
| Address1: | 546 MAIN RD | ||||||||
| Address2: | PRIMA CARE, PC | ||||||||
| City: | TIVERTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028781350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4016248200 | ||||||||
| FaxNumber: | 4016248345 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2005 | ||||||||
| LastUpdateDate: | 11/02/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 82181 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.