MEDICARE: MARY E CLINTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	10604	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760484760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY E CLINTON MD

Provider Business Mailing Address
First Line	:	3443 DICKERSON PIKE
Second Line	:	SUITE 580
City	:	NASHVILLE
State	:	TN
Zip	:	37207-2519
Country	:	US
Telephone Number	:	615-860-1040
Fax Number	:	615-860-1292

Provider Business Practice Location Address
First Line	:	3443 DICKERSON PIKE
Second Line	:	SUITE 580
City	:	NASHVILLE
State	:	TN
Zip	:	37207-2519
Country	:	US
Telephone Number	:	615-860-1040
Fax Number	:	615-860-1292

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	10/28/2014

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Directions to “ MARY E CLINTON MD” Practice Location

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