Individual
DR. JOHN KEVIN CLEMENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT 1457
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3946021
—
TN
01
—
4085057
BLUCROSS BLUESHIELD OF TN
TN
Enumeration date
08/12/2005
Last updated
05/24/2010
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