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General NPI Number Information
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NPI Number | 1831418631
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Entity Type | Organization
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Legal Business Name | CLARK D. LEA, M.D., P.C.
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 05/20/2010
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Provider Practice Location Address
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Address Line | 300 20TH AVE N STE G3
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City | NASHVILLE
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State | TN
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Zip | 37203-2132
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Country | US
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Telephone | 615-284-2532
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Fax | 615-284-2533
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Provider Business Mailing Address
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Address Line | 300 20TH AVE N STE G3
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City | NASHVILLE
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State | TN
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Zip | 37203-2132
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Country | US
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Telephone | 615-284-2532
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Fax | 615-284-2533
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Authorized Official
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Title or Position | OWNER
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Name | CLARK D LEA
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Credential | M.D.
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Telephone | 615-284-2532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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