Healthcare Provider Details

I. General information

NPI: 1831141092
Provider Name (Legal Business Name): JOSEPH H HARPOLE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PARK BLVD
BRISTOL TN
37620
US

IV. Provider business mailing address

3053 W STATE ST
BRISTOL TN
37620-1720
US

V. Phone/Fax

Practice location:
  • Phone: 423-968-1144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number29194
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101246838
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number18237
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: