Douglas M Clark (NPI# 1487682498, PAC ID# 9032002704) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1487682498 |
| PAC ID by PECOS | 9032002704 |
| Professional Enrollment ID | I20040218000115 |
| Full Name | Douglas M Clark |
| Organization Legal Name | DOUGLAS CLARK |
| Address |
2317 S Roane St Harriman TN 37748-8653 |
| Phone Number | 8655900072 |
| Gender | M |
| Credential | PA |
| Medical School | UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE |
| Graduation Year | 1976 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 6002709771 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440031 | ROANE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2317 S Roane St, Harriman, TN 37748-8653 | 8655900072 | DOUGLAS CLARK |
| Organization Legal Name | DOUGLAS CLARK |
| Physicians | 1 |
| Street Address |
2317 S ROANE ST |
| City | HARRIMAN |
| State | TN |
| Zip | 37748-8653 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles R Olsen | Nurse Practitioner | Mental Health Centers and Clinics of Tennessee | 221 Devonia St, Harriman, TN 37748-2006 |
| Renu Bhateja | Psychiatry | Mental Health Centers and Clinics of Tennessee | 221 Devonia St, Harriman, TN 37748-2006 |
| Shelly L Bingham | Clinical Social Worker | Mental Health Centers and Clinics of Tennessee | 221 Devonia St, Harriman, TN 37748-2006 |
| Timothy S Ochs | Certified Registered Nurse Anesthetist (crna) | Priority Anesthesia, Pllc | 412 Devonia St, Harriman, TN 37748-2009 |
| Kenneth Zalewski | Certified Registered Nurse Anesthetist (crna) | Priority Anesthesia, Pllc | 412 Devonia St, Harriman, TN 37748-2009 |
| Melissa R Blair | Nurse Practitioner | The Pulmonary and Sleep Consultants | 412 Devonia St, Suite 201, Harriman, TN 37748-2009 |
| Hassan F Nadrous | Pulmonary Disease | The Pulmonary and Sleep Consultants | 412 Devonia St, Suite 201, Harriman, TN 37748-2009 |
| Christiane G Jernigan | Certified Registered Nurse Anesthetist | Priority Anesthesia, Pllc | 412 Devonia St, Harriman, TN 37748-2009 |
| Lanita Gann | Nurse Practitioner | 401 Devonia St, Harriman, TN 37748-2010 | |
| Meredith Shropshire | Nurse Practitioner | Thompson Oncology Group | 431 Devonia St, Harriman, TN 37748-2010 |
| Find all physicians in zip 37748 | |||
| City | HARRIMAN |
| Zip Code | 37748 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | HARRIMAN + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Douglas M Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.