Provider Demographics
NPI:1922044981
Name:FERRELL, HAROLD W (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:W
Last Name:FERRELL
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 1:1602 HATCHER LANE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401
Mailing Address - Country:US
Mailing Address - Phone:931-388-0777
Mailing Address - Fax:931-388-1548
Practice Address - Street 1:1602 HATCHER LANE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401
Practice Address - Country:US
Practice Address - Phone:931-490-1000
Practice Address - Fax:931-388-1548
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD7446207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200614740Medicaid
50010OtherBLUE CARE/TN CARE
TN3403473Medicaid
TN3403473Medicaid
3403473Medicare ID - Type Unspecified