Provider Demographics
NPI:1962474148
Name:HARRISON, CARY ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:ELIZABETH
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1850 SENTRY OAK CT
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-3764
Mailing Address - Country:US
Mailing Address - Phone:904-529-9953
Mailing Address - Fax:904-542-7467
Practice Address - Street 1:2080 CHILD ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-5005
Practice Address - Country:US
Practice Address - Phone:904-542-7680
Practice Address - Fax:904-542-7467
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI37186-020207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BH9041500OtherDEA REGISTRATION NUMBER