Individual
MR. MARK P CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6616 KIRBY CENTER COVE, MEMPHIS, TN 38115
(901) 363-8400
(901) 363-8644
Mailing address
6616 KIRBY CENTER CV, MEMPHIS, TN 38115
(901) 363-8400
(901) 363-8644
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
MD0000016200
TN
207Y00000X
Otolaryngology Physician
Primary
N7584
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111549001
—
AR
05
—
3013157
—
TN
Enumeration date
06/14/2006
Last updated
10/01/2012
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