Healthcare Provider Details

I. General information

NPI: 1447955455
Provider Name (Legal Business Name): CAMARA PRICHARD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 PEERLESS XING NW
CLEVELAND TN
37312-3784
US

IV. Provider business mailing address

1060 PEERLESS XING NW
CLEVELAND TN
37312-3784
US

V. Phone/Fax

Practice location:
  • Phone: 423-339-5656
  • Fax: 423-339-8889
Mailing address:
  • Phone: 423-339-5656
  • Fax: 423-339-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6993
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: