Provider Demographics
NPI:1831214287
Name:HARRIS, CAROLYN S (DO)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:S
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:138 CAMPBELLSVILLE BYPASS
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-0000
Mailing Address - Country:US
Mailing Address - Phone:270-283-4638
Mailing Address - Fax:270-283-4639
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7001
Practice Address - Country:US
Practice Address - Phone:859-323-2222
Practice Address - Fax:859-323-5090
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY03286207U00000X, 208D00000X, 207UN0902X
VA0102202077207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine