Individual
DR. BEVERLY CLARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
272 ANDREW JACKSON DR, CLARKSVILLE, TN 37043-1723
(931) 980-5375
Mailing address
272 ANDREW JACKSON DR, CLARKSVILLE, TN 37043-1723
(931) 980-5375
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD28806
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3811144
—
TN
05
—
64350994
—
KY
Enumeration date
08/02/2006
Last updated
01/09/2024
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