Clark, S Kathleen

Clark, S Kathleen is an sole proprietor health care provider with primary practice located at 1132 Dow St , Murfreesboro TN 37130-2486. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Clark, S Kathleen can be contacted via phone (615) 896-2617.

Contact Information

Primary practice address
1132 Dow St Murfreesboro TN 37130-2486
Phone: (615) 896-2617
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X MD0000015766 Tennessee
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD0000015766 Tennessee

Profile Details

NPI number 1174608137
LBN Legal business name Clark, S Kathleen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 26th, 2006
Last updated Jan 22nd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174608137 NPPES
Tennessee Other 0018534 TENNESSEE BLUE CROSS BLUE
Tennessee MEDICAID 3032646 TENNESSEE BLUE CROSS BLUE
Tennessee Other 110025193 TENNESSEE BLUE CROSS BLUE

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