Individual
PATRICK W. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 MEDICAL CENTER PKWY, SUITE 330, MURFREESBORO, TN 37129-2567
(615) 396-4464
(615) 396-6748
Mailing address
PO BOX 1252, MURFREESBORO, TN 37133-1252
(615) 396-4464
(615) 396-6748
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
47459
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1524317
—
TN
01
—
4300340
BLUE CROSS BLUE SHIELD
TN
01
—
P00954898
RR MEDICARE
TN
Enumeration date
11/13/2007
Last updated
10/21/2011
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