Organization
JOHN J HARRIS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA CARSON (SECRETARY)
(901) 682-3035
Entity
Organization
Contact information
Practice address
5050 POPLAR AVE, SUITE 618, MEMPHIS, TN 38157-0618
(901) 682-3035
(901) 682-3049
Mailing address
5050 POPLAR AVE, SUITE 618, MEMPHIS, TN 38157-0618
(901) 682-3035
(901) 682-3049
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
004915
TN
2084P0800X
Psychiatry Physician
Primary
04915
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000129
BLUE SHIELD
TN
01
—
262101820
RAILROAD MEDICARE/PIN
TN
05
—
3383409
—
TN
Enumeration date
08/23/2007
Last updated
11/22/2010
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