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Individual

KELLEY B HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1 MEDICAL PARK BLVD, STE 450W, BRISTOL, TN 37620-7430
(423) 968-3713
(423) 968-7352
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
023958
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
384240
ANTHEM
VT
01
4017031
BC
TN
05
5602998
VA
Enumeration date
07/05/2005
Last updated
02/10/2014
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