Individual
HARRY R. HIXSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 LAUREL AVE # N304, KNOXVILLE, TN 37916-1810
(865) 766-6870
Mailing address
2001 LAUREL AVE STE N304, KNOXVILLE, TN 37916-1810
(865) 766-6870
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
0101250533
VA
2085R0204X
Vascular & Interventional Radiology Physician
0101250533
VA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
55556
TN
390200000X
Student in an Organized Health Care Education/Training Program
0116021819
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I303216
MEDICARE
TN
05
—
Q028263
—
TN
Enumeration date
06/26/2009
Last updated
04/09/2021
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