Individual
MARK HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1169 JEFFERSON AVE, MEMPHIS, TN 38104-7217
(901) 425-1880
(901) 725-5768
Mailing address
1169 JEFFERSON AVE, MEMPHIS, TN 38104-7217
(915) 569-3185
(915) 569-1233
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
55126
TN
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
2878
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q008613
—
TN
Enumeration date
01/10/2007
Last updated
01/17/2017
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