person
Douglas Marley Clark, PAC
Medical Physician Assistant in Harriman, Tennessee
NPI 1487682498

Douglas Marley Clark is a Medical Physician Assistant based in Harriman, TN and is specialized in Medical. Douglas Marley Clark practices in Harriman, TN and has the professional credentials of PAC. The NPI Number for Douglas Marley Clark is 1487682498 and holds a License No. PA000000019 (Tennessee).

The current practice location address for Douglas Marley Clark is 2317 S Roane St, Harriman, TN and can be reached out via phone at 865-590-0072 and via fax at 865-590-0069.

Location: 2317 S Roane St, Harriman, TN, 37748-8653
person
Provider Profile Details
NPI Number
1487682498
Provider Name
Douglas Marley Clark
Credential
PAC
Provider Entity Type
Individual
Gender
Male
Address
2317 S Roane St, Harriman, TN, 37748-8653
Phone Number
865-590-0072
Fax Number
865-590-0069
Provider Enumeration Date
06/29/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3723702 05 TN
institution
Provider Business Practice Location Address Details
Address
2317 S Roane St
City
State
Zip
37748-8653
Phone Number
865-590-0072
Fax Number
865-590-0069
person
Provider Business Mailing Address Details
Address
2317 S Roane St
City
State
Zip
37748-8653
Phone Number
865-590-0072
Fax Number
865-590-0069
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA000000019 (Tennessee)
Definition
Definition to come...
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