Reginald B Harris II
Individual provider Active NPI Driver · Madison, AL
NPI 1275249641 · NPPES record last updated Jan 27, 2023
Key facts
- NPI
- 1275249641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 8549760 (AL)
- Practice address
- 1260 Balch Rd Apt 1209
Madison, AL 35757-6419 - Phone
- (334) 498-7741
- NPI assigned
- Jan 27, 2023
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8549760 | AL | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 8549760 | AL | Yes |
Addresses
Primary practice location
1260 Balch Rd Apt 1209
Madison, AL 35757-6419
Mailing address
1260 Balch Rd Apt 1209
Madison, AL 35757-6419
Phone (334) 498-7741
Other providers in Madison, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.