Psychiatry Services Of Clarksville Plc | |
243 Dover Rd Clarksville TN 37042-4155 | |
(315) 523-4253 | |
Not Available |
Full Name | Psychiatry Services Of Clarksville Plc |
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Speciality | Psychiatry & Neurology |
Location | 243 Dover Rd, Clarksville, Tennessee |
Authorized Official Name and Position | James Staudenmeirer (OWNER) |
Authorized Official Contact | 3155234253 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Psychiatry Services Of Clarksville Plc 243 Dover Rd Clarksville TN 37042-4155 Ph: (931) 905-4646 | Psychiatry Services Of Clarksville Plc 243 Dover Rd Clarksville TN 37042-4155 Ph: (315) 523-4253 |
NPI Number | 1912493131 |
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Provider Enumeration Date | 07/11/2018 |
Last Update Date | 12/25/2018 |
Medicare PECOS PAC ID | 7113270380 |
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Medicare Enrollment ID | O20181106000336 |
Identifier | Type | State | Issuer |
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1912493131 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Corrie Lynn Crook |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508823899 PECOS PAC ID: 7214927722 Enrollment ID: I20170201002775 |
Provider Name | James J Staudenmeier |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1174514657 PECOS PAC ID: 6204070402 Enrollment ID: I20181106000443 |
Provider Name | Patrick Crook |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306106240 PECOS PAC ID: 9931442977 Enrollment ID: I20190515001489 |
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