Individual
WILSON MONROE CLEMENTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2108 E 3RD ST, SUITE 300, CHATTANOOGA, TN 37404-2600
(423) 624-5200
(423) 624-4440
Mailing address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2118
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2010-01100
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
42073
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
52593
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1589G
BCBSNC
NC
05
—
5915281
—
NC
05
—
7100070870
—
KY
Enumeration date
10/10/2006
Last updated
12/02/2016
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