Clem, Mark S

Clem, Mark S is an individual health care provider with primary practice located at 9125 Cross Park Dr Suite 200, Knoxville TN 37923-4505. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Clem, Mark S can be contacted via phone (865) 632-5900.

Contact Information

Primary practice address
9125 Cross Park Dr Suite 200 Knoxville TN 37923-4505
Phone: (865) 632-5900
Fax: (865) 546-5227
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 110001634 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA1617 Tennessee

Profile Details

NPI number 1417942657
LBN Legal business name Clem, Mark S
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated Aug 4th, 2016 - about 8 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 1417942657 NPPES
Virginia MEDICAID 010184487

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