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NPI Code Detail

MEDICARE: HENRY L HARRELL III M.D.

MEDICARE: HENRY L HARRELL III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD29104TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104817907
Entity Type Code : Individual
Provider Name (Legal Business Name) : HENRY L HARRELL III M.D.
Provider Business Mailing Address
First Line : 222 22ND AVE N
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1852
Country : US
Telephone Number : 629-255-3486
Fax Number :
Provider Business Practice Location Address
First Line : 222 22ND AVE N
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1852
Country : US
Telephone Number : 629-255-2150
Fax Number : 629-255-4038
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 10/23/2017

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