Individual
MARK S HARRIMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3045 KATE BOND RD, BARTLETT, TN 38133
(901) 381-4664
(901) 373-0809
Mailing address
6077 PRIMACY PKWY STE 140, MEMPHIS, TN 38119-5742
(901) 725-8347
(901) 259-7637
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD0000019879
TN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
19879
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00760205
RR MEDICARE
TN
01
—
0151308
OOL
—
05
—
10505
—
MS
05
—
139241001
—
AR
05
—
1516452
—
TN
01
—
2687125
CIGNA
—
01
—
40MD019879
UNITED HEALTH CARE
—
01
—
4228373
BCBS OF TN
TN
01
—
86961
BCBS
AR
Enumeration date
09/21/2005
Last updated
01/20/2021
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