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Individual

HARRY STONE CREEKMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2201 LOCK B RD N, CLARKSVILLE, TN 37043-8240
(931) 362-2840
Mailing address
2201 LOCK B RD N, CLARKSVILLE, TN 37043-8240
(931) 362-2840

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD0000019119
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000053405
ANTHEM BCBS OF KY
KY
01
0086392
BLUE CROSS BLUE SHIELD TN
TN
01
1342006
UNITED HEALTH CARE
TN
05
3039144
TN
01
5354372
ANTHEM BCBS OF KY
KY
Enumeration date
06/05/2006
Last updated
06/03/2013
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