Mark R Harvey MD PC – Internal Medicine Physician

Key facts

NPI: 1346340320
Entity type: Organization (NPI type 2)
Primary specialty: Internal Medicine Physician 207R00000X
License: 033984 (GA)
Legal business name: MARK R HARVEY MD PC
Practice address: 203 Medical Arts PL
Suite 3
Sandersville, GA 31082
Phone: (478) 552-0967
Fax: (478) 552-8541
NPI assigned: Sep 22, 2006
Organization subpart: No

Authorized official

Name: Mark R Harvey, MD NPI 1053421172
Title: President
Phone: (478) 552-0967

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Mark R Harvey, MD Internal Medicine Physician · Sandersville, GA · NPI 1053421172

Medicare reassignment NPD Authorized official GA · INTERNAL MEDICINE

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
11D0686564	Mark R Harvey MD PC 203 Medical Arts Place Ste 3, Sandersville, GA 31082	Provider-performed microscopy	Mar 9, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in GA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20100929000084	GA	Part B Supplier - Clinic/Group Practice	4880710797	Receives reassigned benefits from 1 practitioner Practice locations: Sandersville, GA

National Provider Directory

Locations

203 Medical Arts Pl
Ste 3
Sandersville, GA 31082
Phone (478) 552-0967

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician Group: 193400000X SINGLE SPECIALTY GROUP	207R00000X	033984	GA	Yes

Addresses

Primary practice location

203 Medical Arts PL
Suite 3
Sandersville, GA 31082

Mailing address

203 Medical Arts PL
Suite 3
Sandersville, GA 31082
Phone (478) 552-0967

Other identifiers

Identifier	Type	State	Issuer
00456079A	Medicaid	GA

Other providers in Sandersville, GA

All providers in Sandersville, GA · Internal Medicine Physician in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.