Provider Demographics
NPI:1245061399
Name:HARKINS, JOHNATHAN PHILLIP (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOHNATHAN
Middle Name:PHILLIP
Last Name:HARKINS
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 1:369 BEAR BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:KATHLEEN
Mailing Address - State:GA
Mailing Address - Zip Code:31047-2829
Mailing Address - Country:US
Mailing Address - Phone:478-397-0459
Mailing Address - Fax:
Practice Address - Street 1:308 COLISEUM DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3865
Practice Address - Country:US
Practice Address - Phone:478-742-2180
Practice Address - Fax:478-745-2623
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant