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Individual

DR. LAURA MACKENZIE HARBIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7945 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1762
(901) 683-0055
(901) 685-2969
Mailing address
7714 POPLAR AVE., SUITE 200 ATTN: CREDENTIALING, GERMANTOWN, TN 38138
(901) 683-0055
(901) 685-2969

Taxonomy

Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
LL51326
SC
207VX0201X
Gynecologic Oncology Physician
Primary
70260
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LL51326
LIMITED LICENSE
SC
Enumeration date
06/23/2017
Last updated
09/10/2024
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