Provider Demographics
NPI:1164827960
Name:HARRIS, DEBORA A (SA-C)
Entity Type:Individual
Prefix:DR
First Name:DEBORA
Middle Name:A
Last Name:HARRIS
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9309 ROYAL MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2068
Mailing Address - Country:US
Mailing Address - Phone:423-822-5109
Mailing Address - Fax:
Practice Address - Street 1:9309 ROYAL MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2068
Practice Address - Country:US
Practice Address - Phone:423-822-5109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant