Organization
CLAY COUNTY OUTPATIENT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO S MAURICIO MD (PRESIDENT)
(931) 243-3576
Entity
Organization
Contact information
Practice address
102 OLD JEFFERSON STREET, CELINA, TN 38551-4040
(931) 243-3576
(931) 243-2751
Mailing address
102 OLD JEFFERSON STREET, CELINA, TN 38551-4040
(931) 243-3576
(931) 243-2751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD7826
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3152445
—
TN
Enumeration date
12/17/2007
Last updated
12/17/2007
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