Provider Demographics
NPI:1366499261
Name:SOLOMON, HARVEY (MD)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:
Last Name:SOLOMON
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:PO BOX 636019
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:158 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030-1083
Practice Address - Country:US
Practice Address - Phone:615-735-1560
Practice Address - Fax:865-291-3228
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA50678207Q00000X, 207P00000X
TN35129207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3865640Medicaid
TN4013727OtherBCBS
TNP00255564OtherRAILROAD MEDICARE
TN3865640Medicaid
TNH34801Medicare UPIN
TN3865640Medicare PIN