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Individual

JUSTIN MARK HARRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
80 VERMONT AVE, OAK RIDGE, TN 37830-6474
(865) 482-4078
(859) 323-1197
Mailing address
80 VERMONT AVE, OAK RIDGE, TN 37830-6474
(865) 482-4078
(859) 323-1197

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4808
TN
207RC0000X
Cardiovascular Disease Physician
Primary
4808
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q067230
TN
Enumeration date
03/22/2018
Last updated
05/16/2024
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