Haralson Medical Clinic, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

16085 Issued in GA

Legal business name

HARALSON MEDICAL CLINIC, PC

Practice address

201 Allen Memorial Dr
Bremen, GA 30110

Phone

(770) 537-4818

Fax

(770) 537-6684

NPI assigned

Aug 7, 2006

Last updated

May 7, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

In Sook Kim, MD

Title

Secretary

Phone

(770) 537-4818

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1851300842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ALLEN MEMORIAL DR",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "30110",
            "telephone_number": "770-537-4818",
            "fax_number": "770-537-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ALLEN MEMORIAL DR",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "30110",
            "telephone_number": "770-537-4818",
            "fax_number": "770-537-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARALSON MEDICAL CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "IN",
        "authorized_official_middle_name": "SOOK",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "770-537-4818",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "16085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300022742B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Deborah I Hansard, M.D.
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• Haralson Spinal Clinics,Inc.
• Melody Harpe, MHP,CPRP
• Healthstat Onsite Clinic HL-a Co
• Candace Kay Heard, RPH
• Jennifer Nicole Higgins, RN

• Family Medicine Physician in Bremen, GA
• Providers in Bremen, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.