Provider Demographics
NPI:1407967854
Name:HARVEY, JAMES SPOTTSWOOD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SPOTTSWOOD
Last Name:HARVEY
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 1:1314 CONCORD RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4361
Mailing Address - Country:US
Mailing Address - Phone:770-333-8889
Mailing Address - Fax:770-333-8948
Practice Address - Street 1:1314 CONCORD RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4361
Practice Address - Country:US
Practice Address - Phone:770-333-8889
Practice Address - Fax:770-333-8948
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17820207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000069792FMedicaid
GA08BDCPJMedicare ID - Type Unspecified
GAD45593Medicare UPIN