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DR. JERRY DEWITT HARRELL MD DTMH
>> Ophthalmology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1780842708
Individual Registrant:DR. JERRY DEWITT HARRELL MD DTMH
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
411 WHITEFIELD AVENUE ST SIMONS ISLAND, GA 31522-2230 US
Tel: 912-638-8237 Fax: --
Tel: 912-638-8237 Fax: --
Contact information for business:
411 WHITEFIELD AVENUE ST SIMONS ISLAND, GA 31522-2230 US
Tel: 912-638-8237 Fax: --
Tel: 912-638-8237 Fax: --
Registration Information:
NPI: 1780842708
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207W00000X | Allopathic & Osteopathic Physicians Ophthalmology | PA | MD028926L |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
