Community Care Walk In Clinic

LBN: Douglas Clark
Community Care Walk In Clinic is an health care organization with primary practice located at 2317 South Roane Street , Harriman TN 37748. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Douglas Clark can be contacted via phone (865) 590-0072, or through Clark, Douglas Marley via phone (865) 590-0072.

Contact Information

Primary practice address
2317 South Roane Street Harriman TN 37748
Phone: (865) 590-0072
Fax: (865) 590-0069
Website:
Map and Directions
Authorized official contact:
Name: Clark, Douglas Marley PAC
Phone: (865) 590-0072

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1487756755
LBN Legal business name Douglas Clark
DBA Doing business as Community Care Walk In Clinic
Authorized official Clark, Douglas Marley PAC
Entity Organization
Organization subpart 1 No
Enumeration date Sep 5th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487756755 NPPES
Tennessee MEDICAID 3723702
Tennessee Other DB1921

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