Douglas Clark, PAC

NPI 1487682498 · on the registry since 2006

Practice

Address: 2317 S Roane St
Community Care Walk In Clinic
Harriman, TN 37748
Phone: (865) 590-0072
Fax: (865) 590-0069
Organisation at this address: Douglas Clark
Kidzcare Pediatrics, Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 363AM0700X
363AM0700X
Licence states on file: TN
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2012-02-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Tennessee