Provider Demographics
NPI:1437911799
Name:AIKEN, HARRISON ELLIS
Entity Type:Individual
Prefix:MR
First Name:HARRISON
Middle Name:ELLIS
Last Name:AIKEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 BUFORD DAM RD APT 4313
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-3279
Mailing Address - Country:US
Mailing Address - Phone:770-778-1523
Mailing Address - Fax:
Practice Address - Street 1:4536 NELSON BROGDON BLVD.
Practice Address - Street 2:BUILDING E SUITE 2
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518
Practice Address - Country:US
Practice Address - Phone:706-415-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty