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Contact Information

CHARLES R HARRIS JR, MD
101 MARTIN LUTHER KING JR DR
FORSYTH, GA31029-1698
 Phone: 478-994-5281
 Fax: 478-994-9781
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Dermatopathology

207ND0900X 07 Physician/Dermatology
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Pediatric Dermatology

207NP0225X 07 Physician/Dermatology
 

Procedural Dermatology

207NS0135X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for CHARLES R HARRIS JR · (Male)

NPI Number 1073590410
Status Active
Credentials MD
Entity Individual
Enumeration date 12/28/2005
Last updated 04/23/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 019692
  • GA Medicaid 003136057
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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