Provider Demographics
NPI:1265897557
Name:HARRIS, WILLIAM JACOB (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JACOB
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7955 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1423
Mailing Address - Country:US
Mailing Address - Phone:614-505-6177
Mailing Address - Fax:614-436-2220
Practice Address - Street 1:7955 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1423
Practice Address - Country:US
Practice Address - Phone:614-505-6177
Practice Address - Fax:614-436-2220
Is Sole Proprietor?:No
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4587111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor