Organization
CLEVELAND MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
2305 CHAMBLISS AVE NW, CLEVELAND, TN 37311-3847
(423) 728-1650
(423) 728-1655
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(888) 287-7705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
TN
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
2084N0400X
Neurology Physician
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3035497
BCBS
TN
05
—
3710154
—
TN
Enumeration date
07/18/2005
Last updated
07/21/2022
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