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NPI Code Detail

MEDICARE: DR. SAMUEL T. HARRIS MD

MEDICARE: DR. SAMUEL T. HARRIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician48753TN
2207R00000XInternal Medicine PhysicianMD.204060LA

General Provider Information

NPI Number : 1821253899
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL T. HARRIS MD
Provider Business Mailing Address
First Line : 3314 OCTOBER LN
Second Line :
City : KNOXVILLE
State : TN
Zip : 37931-3596
Country : US
Telephone Number : 865-474-1154
Fax Number :
Provider Business Practice Location Address
First Line : 8045 ROANE MEDICAL CENTER DR
Second Line :
City : HARRIMAN
State : TN
Zip : 37748-8333
Country : US
Telephone Number : 865-316-3375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2008
Last Update Date : 09/29/2015

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