Individual
MR. EMMITT RAY CLAUD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
201 BLUEBIRD DR, GOODLETTSVILLE, TN 37072-2301
(615) 859-7546
(615) 851-7760
Mailing address
3810 CENTRAL PIKE, HERMITAGE, TN 37076-3494
(815) 744-8554
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
550
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3708943
GROUP MEDICARE NUMBER
TN
Enumeration date
07/03/2006
Last updated
11/16/2022
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