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Blue Ridge Gastroenterology, PC

Organization Active NPI Gastroenterology Physician · Cleveland, TN

NPI 1891801296 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1891801296
Entity type
Organization (NPI type 2)
Primary specialty
Gastroenterology Physician 207RG0100X
Legal business name
BLUE RIDGE GASTROENTEROLOGY, PC
Practice address
110 Dunhill PL NW
Cleveland, TN 37311-3883
Phone
(423) 614-4000
Fax
(423) 614-4107
NPI assigned
Aug 21, 2006
Organization subpart
No

Authorized official

Name
Dr. Marc L. Clark, M.D. NPI 1609982081
Title
President
Phone
(423) 614-4000

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

110 Dunhill Pl NW
Cleveland, TN 37311
Phone (423) 476-2212

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207RG0100X Yes

Addresses

Primary practice location

110 Dunhill PL NW
Cleveland, TN 37311-3883

Mailing address

110 Dunhill PL NW
Cleveland, TN 37311-3883
Phone (423) 614-4000

Other providers in Cleveland, TN

All providers in Cleveland, TN · Gastroenterology Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.