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General NPI Number Information
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NPI Number | 1043241417
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Entity Type | Organization
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Legal Business Name | CLARY FOOTE MD P.C.
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 2319 S ROANE ST
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City | HARRIMAN
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State | TN
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Zip | 37748-8653
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Country | US
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Telephone | 865-882-2800
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Fax | 865-882-3512
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Provider Business Mailing Address
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Address Line | 2319 S ROANE ST
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City | HARRIMAN
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State | TN
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Zip | 37748-8653
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Country | US
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Telephone | 865-882-2800
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Fax | 865-882-3512
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | DR. CLARY PARKER FOOTE
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Credential | MD
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Telephone | 865-882-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 11820
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License Number State | TN
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