Healthcare Provider Details

I. General information

NPI: 1417505108
Provider Name (Legal Business Name): BETHESDA CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 MAIN ST
CLIFTON TN
38425-5544
US

IV. Provider business mailing address

118 SCENIC DR
CLIFTON TN
38425-5333
US

V. Phone/Fax

Practice location:
  • Phone: 931-676-5200
  • Fax: 931-676-5202
Mailing address:
  • Phone: 931-676-7367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALLISON JESSICA SEMS
Title or Position: OWNER
Credential: PA-C
Phone: 931-676-7367