| Clarksville Internal Medicine, Plc | |
|
111 Center Pointe Dr Suite 1 Clarksville TN 37040-8682 | |
| (931) 648-7615 | |
| (931) 648-7616 |
| Full Name | Clarksville Internal Medicine, Plc |
|---|---|
| Speciality | Internal Medicine |
| Location | 111 Center Pointe Dr, Clarksville, Tennessee |
| Authorized Official Name and Position | Bharatkumar R Patel (PRESIDENT) |
| Authorized Official Contact | 9316487615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarksville Internal Medicine, Plc 111 Center Pointe Dr Suite 1 Clarksville TN 37040-8682 Ph: (931) 648-7615 | Clarksville Internal Medicine, Plc 111 Center Pointe Dr Suite 1 Clarksville TN 37040-8682 Ph: (931) 648-7615 |
| NPI Number | 1922256783 |
|---|---|
| Provider Enumeration Date | 09/05/2008 |
| Last Update Date | 04/04/2023 |
| Medicare PECOS PAC ID | 9739255985 |
|---|---|
| Medicare Enrollment ID | O20080911000584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922256783 | NPI | - | NPPES |
| 3096435 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 26865 (Tennessee) | Primary |
| Provider Name | Bharatkumar R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558342097 PECOS PAC ID: 0042234999 Enrollment ID: I20060119000093 |
| Provider Name | Gina Longo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417188707 PECOS PAC ID: 6204972540 Enrollment ID: I20090930000225 |
| Provider Name | Mychele Lynne Lannom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881137735 PECOS PAC ID: 2567745920 Enrollment ID: I20170208002324 |
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