=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720258478
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAVID E HARMON
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/10/2008
-----------------------------------------------------
Last Update Date | 03/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 131 N HENRY ST
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-586-9601
-----------------------------------------------------
Fax | 423-586-9050
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 131 N HENRY ST
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-586-9601
-----------------------------------------------------
Fax | 423-586-9050
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | INSURANCE CLERK
-----------------------------------------------------
Name | MS. HILARY REECE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 423-586-9601
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332H00000X
-----------------------------------------------------
Taxonomy Name | Eyewear Supplier
-----------------------------------------------------
License Number | OD0000001606
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------