Provider Demographics
NPI:1003608431
Name:SMITH, HARRISON JAMES
Entity type:Individual
Prefix:
First Name:HARRISON
Middle Name:JAMES
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 HICKMAN RD APT F2
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6306
Mailing Address - Country:US
Mailing Address - Phone:678-665-2668
Mailing Address - Fax:
Practice Address - Street 1:1010 HICKMAN RD APT F2
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6306
Practice Address - Country:US
Practice Address - Phone:678-665-2668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program