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Individual

ERIC PETER CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2707 CITICO AVENUE, CHATTANOOGA, TN 37406-3402
(423) 624-8588
(423) 622-3069
Mailing address
PO BOX 23446, CHATTANOOGA, TN 37422
(423) 624-8588
(423) 622-3069

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29432
AL
207X00000X
Orthopaedic Surgery Physician
032102
GA
207X00000X
Orthopaedic Surgery Physician
21142
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00932159A
GA
05
3868282
TN
Enumeration date
08/31/2005
Last updated
04/05/2010
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