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Clyde O Southwell, MD
Specialist in Hendersonville, Tennessee
NPI 1346288966

Clyde O Southwell is a Specialist based in Hendersonville, TN. Clyde O Southwell practices in Hendersonville, TN and has the professional credentials of MD. The NPI Number for Clyde O Southwell is 1346288966 and holds a License No. 43085 (Tennessee).

The current practice location address for Clyde O Southwell is 353 New Shackle Island Rd, Hendersonville, TN and can be reached out via phone at 615-822-2214 and via fax at 615-822-6519.

Location: 353 New Shackle Island Rd, Hendersonville, TN, 37075-2379
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1346288966
Provider Name
Clyde O Southwell
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
353 New Shackle Island Rd, Hendersonville, TN, 37075-2379
Phone Number
615-822-2214
Fax Number
615-822-6519
Provider Enumeration Date
06/04/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
N01356 01 SC SC MEDICAID PROVIDER#
14014 01 NC BCBS PROVIDER#
0404464 01 NC EVERCARE
184386 01 NC MEDCOST PROVIDER#
5902491 05 NC
P00278679 01 NC PALMETTO GBA PROVIDER#
FH2967215 01 NC FCC PROVIDER#
institution
Provider Business Practice Location Address Details
Address
353 New Shackle Island Rd
City
Hendersonville
State
Tennessee
Zip
37075-2379
Phone Number
615-822-2214
Fax Number
615-822-6519
person
Provider Business Mailing Address Details
Address
353 New Shackle Island Rd
City
Hendersonville
State
Tennessee
Zip
37075-2379
Phone Number
615-822-2214
Fax Number
615-822-6519
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
43085 (Tennessee)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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