Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 2478 | TN |
NPI | 1134340219 |
---|---|
Provider Name | Dr. Harvey E Matheny |
First Address | Memphis, TN 38133-8191 |
Second Address | Memphis, TN 38133-8191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 15/04/2013 |