Provider Demographics
NPI:1508800905
Name:GARRETT, HARVEY EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:EDWARD
Last Name:GARRETT
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 638
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38101-0638
Mailing Address - Country:US
Mailing Address - Phone:901-747-3066
Mailing Address - Fax:901-747-2966
Practice Address - Street 1:6025 WALNUT GROVE RD STE 301
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2123
Practice Address - Country:US
Practice Address - Phone:901-226-0456
Practice Address - Fax:901-226-0458
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN170682086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00120830Medicaid
TN158592OtherBCBS
TN3025605Medicaid
TND84642Medicare UPIN
TN060047518Medicare ID - Type UnspecifiedRAILROAD MEDICARE
TN158592OtherBCBS
TN3025605Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL NUMBE
MS780000014Medicare ID - Type UnspecifiedMEDICARE NUMBER