Provider Demographics
NPI:1023087194
Name:HARRIS, ARTHUR S (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:S
Last Name:HARRIS
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 1:3511 CIMARRON DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1206
Mailing Address - Country:US
Mailing Address - Phone:423-929-9101
Mailing Address - Fax:423-434-2032
Practice Address - Street 1:215 E WATAUGA AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4629
Practice Address - Country:US
Practice Address - Phone:423-929-9101
Practice Address - Fax:423-434-2032
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9137207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN49725OtherBCBS
TN3171870Medicaid
TNCA7519OtherRAILROAD MEDICARE
TN3171870Medicaid
TNB03498Medicare UPIN