Provider Demographics
NPI:1669489084
Name:HARROVER, JAMES DAVID III (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:HARROVER
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:465 N BELAIR RD
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3188
Mailing Address - Country:US
Mailing Address - Phone:706-854-2160
Mailing Address - Fax:706-854-2930
Practice Address - Street 1:465 N BELAIR RD
Practice Address - Street 2:SUITE 1C
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3188
Practice Address - Country:US
Practice Address - Phone:706-854-2160
Practice Address - Fax:706-854-2930
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
GA045237207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000934964BMedicaid
GAH50675Medicare UPIN
GA000934964BMedicaid