Individual
DR. CLYDE COLUMBUS MATHISON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
144 CONCORD RD DEPT OF, FARRAGUT, TN 37934-2901
(865) 777-1727
(865) 966-0942
Mailing address
FARRAGUT ENT & ALLERGY, 144 CONCORD ROAD, KNOXVILLE, TN 37934-0001
(865) 777-1727
(865) 966-0942
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
47129
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1523167
—
TN
Enumeration date
12/21/2007
Last updated
08/17/2018
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