Provider Demographics
NPI:1851339634
Name:HARNEY, IANTHA LUCILLE (MD)
Entity Type:Individual
Prefix:MRS
First Name:IANTHA
Middle Name:LUCILLE
Last Name:HARNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IANTHA
Other - Middle Name:LUCILLE
Other - Last Name:ALLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:3024 BUSINESS PARK CIR
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3132
Practice Address - Country:US
Practice Address - Phone:615-851-6033
Practice Address - Fax:615-851-2018
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN410152085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3338876Medicaid
TN4133808OtherBCBS
TN4291492OtherBCBS - MTI
TN1509268OtherMEDICAID - TN
TN3338877Medicaid
TN4133805OtherBCBS
TN1509268Medicaid
TN4200560OtherBCBS TN
KY7100039390Medicaid
TN4291492OtherBCBS - MTI
TNI30204Medicare UPIN
TN103I306931Medicare PIN
TN3338876Medicare PIN
TN3338877Medicare PIN