Clark, Dustin Michael

Clark, Dustin Michael is an sole proprietor health care provider with primary practice located at 1420 Tusculum Blvd Laughlin Memorial Hospital, Greeneville TN 37745. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Clark, Dustin Michael can be contacted via phone (423) 787-5000.

Contact Information

Primary practice address
1420 Tusculum Blvd Laughlin Memorial Hospital Greeneville TN 37745
Phone: (423) 787-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 50872 Tennessee
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1285831644
LBN Legal business name Clark, Dustin Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 29th, 2007
Last updated Jul 31st, 2017 - about 9 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 1285831644 NPPES
Texas Other 39020000X RESIDENT IN TRAINING

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