Healthcare Provider Details

I. General information

NPI: 1811978554
Provider Name (Legal Business Name): ANIL HARSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11021 CHAPMAN HWY
SEYMOUR TN
37865
US

IV. Provider business mailing address

1275 DICK LONAS RD UNIT 101
KNOXVILLE TN
37909-1383
US

V. Phone/Fax

Practice location:
  • Phone: 865-579-3720
  • Fax: 865-577-7309
Mailing address:
  • Phone: 865-584-4747
  • Fax: 865-584-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD0000028017
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: