Provider Demographics
NPI:1164739298
Name:HARRY FRIEDMAN CLINIC, PC
Entity Type:Organization
Organization Name:HARRY FRIEDMAN CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBI
Authorized Official - Middle Name:
Authorized Official - Last Name:STODDARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-747-4320
Mailing Address - Street 1:920 ESTATE DR
Mailing Address - Street 2:SUITE 16
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-0601
Mailing Address - Country:US
Mailing Address - Phone:901-747-4320
Mailing Address - Fax:901-747-4324
Practice Address - Street 1:920 ESTATE DR
Practice Address - Street 2:SUITE 16
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-0601
Practice Address - Country:US
Practice Address - Phone:901-747-4320
Practice Address - Fax:901-747-4324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-10
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD005273207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3151055Medicare PIN
TNB02341Medicare UPIN