Provider Demographics
NPI:1588676456
Name:HARMAN, ERIC W (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:W
Last Name:HARMAN
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 1:444 CLINCHFIELD ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3858
Mailing Address - Country:US
Mailing Address - Phone:423-230-2500
Mailing Address - Fax:423-230-2510
Practice Address - Street 1:444 CLINCHFIELD ST STE 2500
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3858
Practice Address - Country:US
Practice Address - Phone:423-230-2500
Practice Address - Fax:423-230-2510
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251024207Q00000X
TN0000031773207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3876583Medicaid
VA005641560Medicaid
VA1588676456Medicaid
VAP01437020OtherRR MEDICARE
TN3876583Medicare PIN
VA005641560Medicaid
VAVV4686AMedicare PIN
TN103I083131Medicare PIN