Organization
DOUGLAS CLARK
Active
Other names
Community Care Walk In Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS MARLEY CLARK PAC (OWNER)
(865) 590-0072
Entity
Organization
Contact information
Practice address
2317 SOUTH ROANE STREET, HARRIMAN, TN 37748
(865) 590-0072
(865) 590-0069
Mailing address
2317 SOUTH ROANE STREET, HARRIMAN, TN 37748
(865) 590-0072
(865) 590-0069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3723702
—
TN
01
—
DB1921
RAILROAD MCARE
—
Enumeration date
09/05/2006
Last updated
08/22/2020
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