# BLUE RIDGE GASTROENTEROLOGY, PC

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

## Provider details

- **NPI number:** 1891801296
- **Authorized official:** DR. MARC L. CLARK M.D. (PRESIDENT)
- **Authorized official phone:** (423) 614-4000

## Contact information

- **Practice address:** 110 DUNHILL PL NW, CLEVELAND, TN 37311-3883
- **Practice address phone:** (423) 614-4000
- **Practice address fax:** (423) 614-4107
- **Mailing address:** 110 DUNHILL PL NW, CLEVELAND, TN 37311-3883
- **Mailing address phone:** (423) 614-4000
- **Mailing address fax:** (423) 614-4107

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 08/22/2020