Basic Information
Provider Information
NPI: 1205188760
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARPER
FirstName: YENAL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P O BOX 1000 DEPT 960
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381480001
CountryCode: US
TelephoneNumber: 9017589900
FaxNumber: 9017522335
Practice Location
Address1: 3950 NEW COVINGTON PIKE STE 220
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381282595
CountryCode: US
TelephoneNumber: 9017630200
FaxNumber: 9015165370
Other Information
ProviderEnumerationDate: 10/09/2012
LastUpdateDate: 08/29/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X58865TNN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RI0011X58865TNY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

No ID Information.


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