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General NPI Number Information
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NPI Number | 1093235715
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Entity Type | Individual
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Provider Name | LAURA MACKENZIE HARBIN MD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 7945 WOLF RIVER BLVD
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City | GERMANTOWN
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State | TN
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Zip | 38138-1762
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Country | US
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Telephone | 901-683-0055
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Fax | 901-685-2969
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Provider Business Mailing Address
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Address Line | 7714 POPLAR AVE. SUITE 200 ATTN: CREDENTIALING
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City | GERMANTOWN
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State | TN
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Zip | 38138
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Country | US
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Telephone | 901-683-0055
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Fax | 901-685-2969
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 70260
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | LL51326
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License Number State | SC
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