Individual
JONATHAN CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
917 W WALNUT ST, JOHNSON CITY, TN 37604-6527
(561) 635-6300
Mailing address
3203 BUCKINGHAM DR, JOHNSON CITY, TN 37604-2775
(561) 635-6300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NA
TN
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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