Provider Demographics
NPI:1265441745
Name:HARRISON, STEPHEN HOPKINS (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:HOPKINS
Last Name:HARRISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 E DIVISION RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6907
Mailing Address - Country:US
Mailing Address - Phone:865-482-9633
Mailing Address - Fax:865-482-9655
Practice Address - Street 1:129 E DIVISION RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6907
Practice Address - Country:US
Practice Address - Phone:865-482-9633
Practice Address - Fax:865-482-9655
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000013263174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist