Provider Demographics
NPI:1730110917
Name:SONI & SONI M.D. P.C.
Entity Type:Organization
Organization Name:SONI & SONI M.D. P.C.
Other - Org Name:DR. HARISH SONI
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:B
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-263-1147
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:109 GRADY RD SUITE B
Mailing Address - City:E TOWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37331
Mailing Address - Country:US
Mailing Address - Phone:423-263-1147
Mailing Address - Fax:423-263-5704
Practice Address - Street 1:MEDICAL ARTS BLDG
Practice Address - Street 2:
Practice Address - City:ETOWAH
Practice Address - State:TN
Practice Address - Zip Code:37331-0500
Practice Address - Country:US
Practice Address - Phone:423-263-1147
Practice Address - Fax:423-263-5704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000009198208600000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2006386OtherBCBS
B04722Medicare UPIN
TN0035Medicare ID - Type UnspecifiedGROUP NUMBER