Provider Demographics
NPI:1477590404
Name:HARRIS, DENNIS G (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:G
Last Name:HARRIS
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 1:420 W MORRIS BLVD
Mailing Address - Street 2:STE 130
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2283
Mailing Address - Country:US
Mailing Address - Phone:423-581-3939
Mailing Address - Fax:423-318-2200
Practice Address - Street 1:420 W MORRIS BLVD
Practice Address - Street 2:STE 130
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2283
Practice Address - Country:US
Practice Address - Phone:423-581-3939
Practice Address - Fax:423-318-2200
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD17057207LP2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3020922Medicaid
TNA98467Medicare UPIN
TN3020922Medicaid
TN3020926Medicare PIN
TN3020922Medicaid
TN103I050193Medicare PIN