Provider Demographics
NPI:1528055373
Name:HARREL, ELIZABETH M (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:M
Last Name:HARREL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:110 EXECUTIVE PARK DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-6876
Mailing Address - Country:US
Mailing Address - Phone:865-494-9241
Mailing Address - Fax:865-494-2522
Practice Address - Street 1:110 EXECUTIVE PARK DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-6876
Practice Address - Country:US
Practice Address - Phone:865-494-9241
Practice Address - Fax:865-494-2522
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000029300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3070005OtherBLUE CROSS
TN3813755Medicaid
TN080112502OtherRAILROAD MEDICARE
TN3813755Medicare PIN
TN3813755Medicaid