Healthcare Provider Details

I. General information

NPI: 1356326011
Provider Name (Legal Business Name): JOHN E B HARRISON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 W CLINCH AVE SUITE 100
KNOXVILLE TN
37916-2434
US

IV. Provider business mailing address

PO BOX 32569
KNOXVILLE TN
37930-2569
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-5365
  • Fax: 865-673-8007
Mailing address:
  • Phone: 865-694-0062
  • Fax: 865-694-7907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number16309
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: