MEDICARE: HARRIS MEDICAL CLINICS INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	208000000X	Pediatrics Physician
2	208600000X	Surgery Physician
3	207X00000X	Orthopaedic Surgery Physician
4	207Q00000X	Family Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1588663660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRIS MEDICAL CLINICS INC.

Provider Business Mailing Address
First Line	:	7100 COMMERCE WAY
Second Line	:	SUITE 180
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-2829
Country	:	US
Telephone Number	:	615-465-7626
Fax Number	:	615-465-3007

Provider Business Practice Location Address
First Line	:	1200 MCLAIN ST
Second Line	:
City	:	NEWPORT
State	:	AR
Zip	:	72112-3534
Country	:	US
Telephone Number	:	870-523-2320
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PROVIDER ENROLLMENT
Name	:	DEBBIE BREWER
Credential	:
Telephone Number	:	615-465-7626

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	08/06/2009

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Directions to “HARRIS MEDICAL CLINICS INC. ” Practice Location

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