Individual
PRABODH MISHRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
647 DULOP SUITE 200, CLARKSVILLE, TN 37040
(931) 648-0064
(931) 553-4215
Mailing address
300 20TH AVE N STE 403, NASHVILLE, TN 37203-5180
(931) 648-0064
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
65950
TN
207R00000X
Internal Medicine Physician
LL39709
SC
207RC0000X
Cardiovascular Disease Physician
Primary
65950
TN
Other
Enumeration date
06/27/2016
Last updated
12/14/2022
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