Provider Demographics
NPI:1851287122
Name:HARRIS, DARTAGNAN LEE (PA-C)
Entity type:Individual
Prefix:
First Name:DARTAGNAN
Middle Name:LEE
Last Name:HARRIS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E MAIN ST APT 1354
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-4370
Mailing Address - Country:US
Mailing Address - Phone:913-991-5626
Mailing Address - Fax:
Practice Address - Street 1:1409 N FANT ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4825
Practice Address - Country:US
Practice Address - Phone:864-231-8599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program