Individual
DR. RICHARD GARY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 S DUNCAN ST, JAMESTOWN, TN 38556-3009
(931) 879-5864
(931) 879-3903
Mailing address
PO BOX 2861, CROSSVILLE, TN 38557-2861
(931) 879-5864
(931) 879-3903
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
11080
TN
207R00000X
Internal Medicine Physician
Primary
11080
TN
208M00000X
Hospitalist Physician
11080
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4053283
—
TN
Enumeration date
06/09/2005
Last updated
03/25/2024
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