Individual
M CLARK COLVARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4632 BATTLEFIELD PKWY, RINGGOLD, GA 30736-8004
(706) 806-0170
Mailing address
1604 GUNBARREL RD, CHATTANOOGA, TN 37421-3125
(423) 648-2395
(423) 648-7542
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
028388
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000318216C
—
GA
05
—
000318216D
—
GA
05
—
000318216F
—
GA
01
—
060004408
RR MEDICARE
—
01
—
54121
BX TN
—
Enumeration date
03/27/2006
Last updated
06/25/2025
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