# JOHN T CLARDY SR MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215126644
- **Authorized official:** JOHN THOMAS CLARDY SR. M.D (PRESIDENT/PHYSCIAN)
- **Authorized official phone:** (931) 503-0182

## Contact information

- **Practice address:** 215 8TH ST, CLARKSVILLE, TN 37040-3249
- **Practice address phone:** (931) 503-0182
- **Practice address fax:** (931) 503-0192
- **Mailing address:** 215 8TH ST, CLARKSVILLE, TN 37040-3249
- **Mailing address phone:** (931) 503-0182
- **Mailing address fax:** (931) 503-0192

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | MD0000030062 | TN | Yes |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | MD0000030062 | TN | — |

## Other

- **Enumeration date:** 10/22/2007
- **Last updated:** 01/21/2008