Provider Demographics
NPI:1154478386
Name:HARWELL, WILLIAM BEASLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BEASLEY
Last Name:HARWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1900 PATTERSON STREET
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2165
Mailing Address - Country:US
Mailing Address - Phone:615-329-0011
Mailing Address - Fax:615-329-3056
Practice Address - Street 1:1900 PATTERSON STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2165
Practice Address - Country:US
Practice Address - Phone:615-329-0011
Practice Address - Fax:615-329-3056
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000007488207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB03052Medicare UPIN