Provider Demographics
NPI:1215375191
Name:HARRIS, LAURIE CHRISTINE (DO)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:CHRISTINE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:CHRISTINE
Other - Last Name:HOYT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:860 OMNI BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-232-8875
Practice Address - Street 1:2205 EXECUTIVE DR STE A
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2948
Practice Address - Country:US
Practice Address - Phone:757-825-4273
Practice Address - Fax:757-825-4276
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116026167207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine