Provider Demographics
NPI:1750393948
Name:HEMPHILL HARRIS, KARLA EILEEN (DO)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:EILEEN
Last Name:HEMPHILL HARRIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GREENWAY BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4338
Mailing Address - Country:US
Mailing Address - Phone:770-838-8710
Mailing Address - Fax:
Practice Address - Street 1:2908 BUSINESS 27
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:GA
Practice Address - Zip Code:30113-4857
Practice Address - Country:US
Practice Address - Phone:770-646-8281
Practice Address - Fax:770-646-3579
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA94154207Q00000X
MI5101013504207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003284854DMedicaid
MI0D16477017Medicare ID - Type Unspecified
MIH87096Medicare UPIN