Provider Demographics
NPI:1407898414
Name:HARRISON, A. NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:A.
Middle Name:NEIL
Last Name:HARRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 TREE LANE RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6782
Mailing Address - Country:US
Mailing Address - Phone:770-979-4700
Mailing Address - Fax:770-979-1060
Practice Address - Street 1:1700 TREE LANE RD
Practice Address - Street 2:SUITE 230
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6782
Practice Address - Country:US
Practice Address - Phone:770-979-4700
Practice Address - Fax:770-979-1060
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025761207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00356749AMedicaid
GA00356749AMedicaid