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General NPI Number Information
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NPI Number | 1558863852
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Entity Type | Organization
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Legal Business Name | CLARKSDALE REGIONAL PHYSICIANS, LLC
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Dates
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Enumeration Date | 03/02/2018
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Last Update Date | 03/02/2018
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Provider Practice Location Address
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Address Line | 1970 HOSPITAL DR
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City | CLARKSDALE
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State | MS
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Zip | 38614-7202
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Country | US
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Telephone | 662-621-5019
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 MIDPARK RD
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City | KNOXVILLE
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State | TN
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Zip | 37921-5977
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Country | US
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Telephone | 865-269-4074
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVE CLAPP
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Credential |
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Telephone | 865-269-4074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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