Provider Demographics
NPI:1023000999
Name:WOMACK, CLARA R (MD)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:R
Last Name:WOMACK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:393 WALLACE RD STE 301
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4834
Practice Address - Country:US
Practice Address - Phone:615-628-8064
Practice Address - Fax:877-297-3060
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16426207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3046652Medicaid
TN3046656Medicare ID - Type UnspecifiedMEDICARE, CIGNA, PART B
TN3046652Medicaid