Keith R Harris (NPI# 1922090224, PAC ID# 3274527908) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1922090224 |
| PAC ID by PECOS | 3274527908 |
| Professional Enrollment ID | I20040414000360 |
| Full Name | Keith R Harris |
| Organization Legal Name | NORTHWEST GEORGIA DERMATOLOGY AND SKIN SURGERY CENTER PC |
| Address |
100 Market Place Blvd Suite 300 Cartersville GA 30121-8717 |
| Phone Number | 7703348821 |
| Gender | M |
| Credential | MD |
| Medical School | TULANE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1991 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 8628066099 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110054 | FLOYD MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 100 Market Place Blvd, Suite 300, Cartersville, GA 30121-8717 | 7703348821 | NORTHWEST GEORGIA DERMATOLOGY AND SKIN SURGERY CENTER PC |
| 103 John Maddox Nwdr, Rome, GA 30165-1419 | 706235771114 | NORTHWEST GEORGIA DERMATOLOGY AND SKIN SURGERY CENTER PC |
| Organization Legal Name | NORTHWEST GEORGIA DERMATOLOGY AND SKIN SURGERY CENTER PC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dora E Mciver | Physician Assistant | Northwest Georgia Dermatology and Skin Surgery Center PC | 100 Market Place Blvd, Suite 300, Cartersville, GA 30121-8717 |
| Jason Smith | Dermatology | Northwest Georgia Dermatology and Skin Surgery Center PC | 103 John Maddox Nwdr, Rome, GA 30165-1419 |
| Street Address |
100 MARKET PLACE BLVD SUITE 300 |
| City | CARTERSVILLE |
| State | GA |
| Zip | 30121-8717 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dora E Mciver | Physician Assistant | Northwest Georgia Dermatology and Skin Surgery Center PC | 100 Market Place Blvd, Suite 300, Cartersville, GA 30121-8717 |
| Aman Mongia | Internal Medicine | Center for Infectious Diseases LLC | 100 Market Place Blvd, Suite 207, Cartersville, GA 30121-8716 |
| Anu Mongia | Allergy/immunology | Center for Infectious Diseases LLC | 100 Market Place Blvd, Suite 207, Cartersville, GA 30121-8716 |
| Kamal Kishore Mandalapu | Hematology/oncology | Wellstar Medical Group, LLC | 100 Market Place Blvd, Suite 102, Cartersville, GA 30121-8715 |
| Alexandra D Tuuk | Physician Assistant | Northwest Georgia Oncology Centers, PC | 100 Market Place Blvd, Suite 200, Cartersville, GA 30121-8716 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Irene Ibenyenwa | Nurse Practitioner | 22 Maple Ridge Dr, Cartersville, GA 30121-2228 | |
| Larry R Brown | Optometry | 101 Market Place Blvd, Cartersville, GA 30121-2236 | |
| Meredith Duggan | Nurse Practitioner | Peachtree Immediate Care Fp, LLC | 122 N Morningside Dr, Cartersville, GA 30121-2912 |
| Jason Salisbury | Physical Therapy | Physiotherapy Associates Inc | 110 Cherokee Pl, Cartersville, GA 30121-2954 |
| Ansley Della Taylor | Physical Therapy | Physiotherapy Associates Inc | 110 Cherokee Pl, Cartersville, GA 30121-2954 |
| Shraddha Patel | Physical Therapy | Physiotherapy Associates Inc | 110 Cherokee Pl, Cartersville, GA 30121-2954 |
| Amana Eliora Andrews | Family Medicine | Eastside Urgent Care LLC | 10 Main St Market Pl Se, Cartersville, GA 30121-3309 |
| David E Kim | Internal Medicine | 491 E Main St, Cartersville, GA 30121-3353 | |
| Margaret Ladell Conley | Clinical Social Worker | 24 A Falcon Cir Nw, Cartersville, GA 30121-7362 | |
| Jacqueline K Foley | Occupational Therapy | Hand Therapy Services Inc | 12 Medical Dr Ne, Cartersville, GA 30121-8002 |
| Find all physicians in zip 30121 | |||
| City | CARTERSVILLE |
| Zip Code | 30121 |
| Specialty | DERMATOLOGY |
| City + Specialty | CARTERSVILLE + DERMATOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.