| John J Harris Md Pc | |
|
5050 Poplar Ave Suite 618 Memphis TN 38157-0618 | |
| (901) 682-3035 | |
| (901) 682-3049 |
| Full Name | John J Harris Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5050 Poplar Ave, Memphis, Tennessee |
| Authorized Official Name and Position | Donna Carson (SECRETARY) |
| Authorized Official Contact | 9016823035 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John J Harris Md Pc 5050 Poplar Ave Suite 618 Memphis TN 38157-0618 Ph: (901) 682-3035 | John J Harris Md Pc 5050 Poplar Ave Suite 618 Memphis TN 38157-0618 Ph: (901) 682-3035 |
| NPI Number | 1396938239 |
|---|---|
| Provider Enumeration Date | 08/23/2007 |
| Last Update Date | 11/22/2010 |
| Medicare PECOS PAC ID | 5597951418 |
|---|---|
| Medicare Enrollment ID | O20140714001216 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396938239 | NPI | - | NPPES |
| 2000129 | Other | TN | BLUE SHIELD |
| 3383409 | Medicaid | TN | |
| 262101820 | Other | TN | RAILROAD MEDICARE/PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | 004915 (Tennessee) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 04915 (Tennessee) | Primary |
| Provider Name | John J Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992863864 PECOS PAC ID: 1850586553 Enrollment ID: I20101108000861 |
| Provider Name | Allyson B Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407115579 PECOS PAC ID: 0143485219 Enrollment ID: I20120625000067 |
| Provider Name | Alam E Sharifi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669873774 PECOS PAC ID: 8224353123 Enrollment ID: I20150218000606 |
| Provider Name | Sarah A Dietrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396149951 PECOS PAC ID: 6507183381 Enrollment ID: I20150317000833 |
| Provider Name | Alexander Labrador |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528516788 PECOS PAC ID: 7810269834 Enrollment ID: I20190508003504 |
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