Provider Demographics
NPI:1174584403
Name:WARNER, HARRISON FREDERICK (MD)
Entity type:Individual
Prefix:DR
First Name:HARRISON
Middle Name:FREDERICK
Last Name:WARNER
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 1:2004 HAYES ST # LL30
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2646
Mailing Address - Country:US
Mailing Address - Phone:615-284-7950
Mailing Address - Fax:615-284-5750
Practice Address - Street 1:2000 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37236-7541
Practice Address - Country:US
Practice Address - Phone:615-284-5229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40852207ZD0900X, 207ZP0102X
SC23866207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC23866OtherSC MEDICAL LICENSE #
AL009937112Medicaid
KY64116353Medicaid
VA0101058114OtherVA MEDICAL LICENSE#
TN1509868Medicaid
TN000000037471OtherTLC TENNCARE
VA010335884Medicaid
TN100051008OtherPHP TENNCARE
TN4123407OtherBLUE CROSS
TN187244OtherUNISON TENNCARE
NC200301076OtherNC MEDICAL LICENSE#