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NPI Code Detail

MEDICARE: CLARKSVILLE PHYSICIAN SERVICES LLC

MEDICARE: CLARKSVILLE PHYSICIAN SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician
2208600000XSurgery Physician
3208800000XUrology Physician
4363L00000XNurse Practitioner
5207Q00000XFamily Medicine Physician
6363A00000XPhysician Assistant
7207RC0000XCardiovascular Disease Physician
8207X00000XOrthopaedic Surgery Physician
9208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
10207RG0100XGastroenterology Physician
11208D00000XGeneral Practice Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083657829
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARKSVILLE PHYSICIAN SERVICES LLC
Provider Business Mailing Address
First Line : 3841 GREEN HILLS VILLAGE DR STE 200
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-2691
Country : US
Telephone Number : 470-351-0247
Fax Number : 615-875-8618
Provider Business Practice Location Address
First Line : 651 DUNLOP LN
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-5015
Country : US
Telephone Number : 931-502-5080
Fax Number : 931-502-5081
Authorized Official
Title or Position : VICE PRESIDENT
Name : WENDY MONACI
Credential :
Telephone Number : 615-343-9094
Provider Enumeration Date : 06/13/2006
Last Update Date : 06/09/2026

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Directions to “CLARKSVILLE PHYSICIAN SERVICES LLC ” Practice Location

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