| Blane Clinical LLC | |
|
1307 Donelson Pkwy Dover TN 37058-3724 | |
| (931) 232-0123 | |
| (931) 232-1185 |
| Full Name | Blane Clinical LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1307 Donelson Pkwy, Dover, Tennessee |
| Authorized Official Name and Position | Marlin Blane (AO) |
| Authorized Official Contact | 3128201126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blane Clinical LLC 1307 Donelson Pkwy Dover TN 37058-3724 Ph: (931) 232-0123 | Blane Clinical LLC 1307 Donelson Pkwy Dover TN 37058-3724 Ph: (931) 232-0123 |
| NPI Number | 1730906348 |
|---|---|
| Provider Enumeration Date | 09/24/2024 |
| Last Update Date | 10/14/2025 |
| Certification Date | 10/14/2025 |
| Medicare PECOS PAC ID | 6305334129 |
|---|---|
| Medicare Enrollment ID | O20251023001852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730906348 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| 3336C0002X | Pharmacy - Clinic Pharmacy | () | Secondary |
| Provider Name | Michael a Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639293871 PECOS PAC ID: 2567503162 Enrollment ID: I20100105000131 |
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