Provider Demographics
NPI:1225594674
Name:HARVEY, ALPHONSO
Entity Type:Individual
Prefix:
First Name:ALPHONSO
Middle Name:
Last Name:HARVEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 28TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-1204
Mailing Address - Country:US
Mailing Address - Phone:615-480-7102
Mailing Address - Fax:
Practice Address - Street 1:810 DOMINICAN DR # 223
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1906
Practice Address - Country:US
Practice Address - Phone:800-613-7916
Practice Address - Fax:800-613-7916
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other