Provider Demographics
NPI:1295472108
Name:HARRIS, THOMAS BRIAN
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BRIAN
Last Name:HARRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:MRS
Other - First Name:MICHELLE LEE
Other - Middle Name:TOWE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1216 E LITTLE CREEK RD STE 200B
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-3900
Mailing Address - Country:US
Mailing Address - Phone:757-324-5677
Mailing Address - Fax:757-324-5677
Practice Address - Street 1:1216 E LITTLE CREEK RD STE 200B
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-3900
Practice Address - Country:US
Practice Address - Phone:757-324-5677
Practice Address - Fax:757-324-5677
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health