Individual
STEPHEN H PERCELAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
651 DUNLOP LN, CLARKSVILLE, TN 37040-5015
(931) 502-1000
Mailing address
PO BOX 3098, CLARKSVILLE, TN 37043-3098
(931) 647-5034
(931) 552-6663
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300050066
RAILROAD MEDICARE
—
01
—
300133944
RAILROAD MEDICARE CIC
—
01
—
3030831
BCBS
—
05
—
3092082
—
TN
01
—
4035743
BCBS CIC
—
Enumeration date
02/20/2006
Last updated
06/09/2008
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