Harris, Kevin Russell
Harris, Kevin Russell is an individual health care provider with primary practice located at 2620 Centron Dr Sw , Decatur AL 35603-2500. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Harris, Kevin Russell can be contacted via phone (256) 350-6655.Contact Information
Primary practice address
2620 Centron Dr Sw
Decatur AL 35603-2500
Phone: (256) 350-6655
Fax: (256) 350-2548
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | S813 TA107 | Alabama |
Profile Details
| NPI number | 1194863183 |
|---|---|
| LBN Legal business name | Harris, Kevin Russell |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 2nd, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1194863183 | NPPES |
| Alabama | MEDICAID | 000-79209 |
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