| Douglas Clark | |
|
2317 South Roane Street Harriman TN 37748 | |
| (865) 590-0072 | |
| (865) 590-0069 |
| Full Name | Douglas Clark |
|---|---|
| Speciality | Family Medicine |
| Location | 2317 South Roane Street, Harriman, Tennessee |
| Authorized Official Name and Position | Douglas Marley Clark (OWNER) |
| Authorized Official Contact | 8655900072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas Clark 2317 South Roane Street Harriman TN 37748 Ph: (865) 590-0072 | Douglas Clark 2317 South Roane Street Harriman TN 37748 Ph: (865) 590-0072 |
| NPI Number | 1487756755 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487756755 | NPI | - | NPPES |
| 3723702 | Medicaid | TN | |
| DB1921 | Other | RAILROAD MCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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