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General NPI Number Information
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NPI Number | 1346288966
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Entity Type | Individual
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Provider Name | CLYDE O SOUTHWELL MD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 102 WESSINGTON PL
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3085
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Country | US
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Telephone | 615-822-2214
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Fax |
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Provider Business Mailing Address
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Address Line | 3024 BUSINESS PARK CIR
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3132
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Country | US
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Telephone | 615-239-2018
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 43085
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 43085
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 43085
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License Number State | TN
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