Provider Demographics
NPI:1891205076
Name:FORD, HARRY NATHANIEL JR
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:NATHANIEL
Last Name:FORD
Suffix:JR
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 1:107 MOSS SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-5140
Mailing Address - Country:US
Mailing Address - Phone:980-282-0896
Mailing Address - Fax:
Practice Address - Street 1:107 MOSS SPRINGS RD
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-5140
Practice Address - Country:US
Practice Address - Phone:980-282-0896
Practice Address - Fax:980-282-0896
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi