Individual
PRADIP K MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
647 DUNLOP LN STE 200, CLARKSVILLE, TN 37040-5165
(931) 648-0064
(931) 553-4215
Mailing address
647 DUNLOP LN STE 200, CLARKSVILLE, TN 37040-5165
(931) 920-0228
(931) 920-2191
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
29165
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517323
—
TN
01
—
29165
LICENSE
TN
05
—
3119169
—
TN
Enumeration date
10/06/2006
Last updated
03/13/2023
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