Dustin Michael Clark, MD | |
1420 Tusculum Blvd, Laughlin Memorial Hospital, Greeneville, TN 37745 | |
(423) 787-5000 | |
Not Available |
Full Name | Dustin Michael Clark |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 1420 Tusculum Blvd, Greeneville, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285831644 | NPI | - | NPPES |
39020000X | Other | TX | RESIDENT IN TRAINING |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 50872 (Tennessee) | Primary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Entity Name | Southeastern Emergency Physicians Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050125000997 |
Mailing Address | Practice Location Address |
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Dustin Michael Clark, MD 900 Melrose Cir, Johnson City, TN 37601-2114 Ph: () - | Dustin Michael Clark, MD 1420 Tusculum Blvd, Laughlin Memorial Hospital, Greeneville, TN 37745 Ph: (423) 787-5000 |
Edward Crutchfield, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 401 Takoma Ave, Emergency Department, Greeneville, TN 37743 Phone: 423-639-3151 Fax: 423-636-2374 | |
Dr. Ann Celine Chang, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1420 Tusculum Blvd, Greeneville, TN 37745 Phone: 423-787-5000 | |
Callen Ruth Hardin, ATC Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 7469 Asheville Hwy, Greeneville, TN 37743 Phone: 423-636-3790 | |
Susan N. Obrien, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 401 Takoma Ave, Emergency Dept., Greeneville, TN 37743 Phone: 423-639-3151 | |
Remy Sagadraca, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1406 Tusculum Blvd Ste 2004, Greeneville, TN 37745 Phone: 423-787-5000 | |
Dr. Drew P. Mcfarland Iv, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 109 E Church St, Greeneville, TN 37745 Phone: 423-638-4131 Fax: 423-638-9239 |