Clemons, Mark P

Clemons, Mark P is an sole proprietor health care provider with primary practice located at 6616 Kirby Center Cove , Memphis TN 38115. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Clemons, Mark P can be contacted via phone (901) 363-8400.

Contact Information

Primary practice address
6616 Kirby Center Cove Memphis TN 38115
Phone: (901) 363-8400
Fax: (901) 363-8644
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X MD0000016200 Tennessee
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X N7584 Arkansas

Profile Details

NPI number 1457394611
LBN Legal business name Clemons, Mark P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Oct 1st, 2012 - about 14 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 1457394611 NPPES
Tennessee MEDICAID 3013157
Tennessee MEDICAID 111549001

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