Basic Information
Provider Information
NPI: 1811929193
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARRETT
FirstName: HARRIS
MiddleName: G.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 850489
Address2:  
City: MOBILE
State: AL
PostalCode: 366850489
CountryCode: US
TelephoneNumber: 2513423949
FaxNumber: 2516313361
Practice Location
Address1: 5907 HIGHWAY 90
Address2:  
City: MOSS POINT
State: MS
PostalCode: 395636536
CountryCode: US
TelephoneNumber: 2287692611
FaxNumber: 2287621638
Other Information
ProviderEnumerationDate: 07/07/2006
LastUpdateDate: 10/22/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X08694MSY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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