Individual
JOHN B CLENDENIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1412 E REELFOOT AVE, UNION CITY, TN 38261-5813
(731) 885-5131
(731) 885-5335
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5827
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25947
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080090136
RAILROAD MEDICARE
TN
05
—
3084699
—
TN
Enumeration date
01/20/2006
Last updated
10/25/2016
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