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NPI Code Detail

MEDICARE: DR. CLARENCE B CREECH II MD

MEDICARE: DR. CLARENCE B CREECH II MD
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
1208000000XPediatrics PhysicianMD37162TN
22080P0204XPediatric Emergency Medicine (Pediatrics) PhysicianMD37162TN
32080P0208XPediatric Infectious Diseases PhysicianMD37162TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1620476822OTHERTAX ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093742033
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLARENCE B CREECH II MD
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 : 615-322-3573
Fax Number : 615-936-6095
Provider Business Practice Location Address
First Line : 3601 THE VANDERBILT CLINIC
Second Line :
City : NASHVILLE
State : TN
Zip : 37232-5100
Country : US
Telephone Number : 615-322-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2006
Last Update Date : 03/29/2022

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