Healthcare Provider Details

I. General information

NPI: 1376523910
Provider Name (Legal Business Name): LEWIS W HARRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W CLINCH AVE STE 110
KNOXVILLE TN
37916-2219
US

IV. Provider business mailing address

1932 ALCOA HWY STE 360
KNOXVILLE TN
37920-1527
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-1869
  • Fax: 865-544-6533
Mailing address:
  • Phone: 865-524-1869
  • Fax: 865-544-6533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number26914
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: