Provider Demographics
NPI:1174706279
Name:HARRIS, RONALD TERRELL (RRT)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:TERRELL
Last Name:HARRIS
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 N WEST ST APT 205
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-1559
Mailing Address - Country:US
Mailing Address - Phone:601-750-2280
Mailing Address - Fax:
Practice Address - Street 1:1505 N WEST ST APT 205
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-1559
Practice Address - Country:US
Practice Address - Phone:601-750-2280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSRCP3303227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered