Provider Demographics
NPI:1083626915
Name:GARRARD, CLIFFORD L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:L
Last Name:GARRARD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2839 HIGHWAY 231 N
Mailing Address - Street 2:STE 208
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-7447
Mailing Address - Country:US
Mailing Address - Phone:931-685-5533
Mailing Address - Fax:931-685-5544
Practice Address - Street 1:2839 HIGHWAY 231 N
Practice Address - Street 2:STE 208
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7449
Practice Address - Country:US
Practice Address - Phone:931-685-5533
Practice Address - Fax:931-685-5544
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD04675207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN01052446OtherAMERIGROUP
TN203513106001OtherTRICARE SOUTH
TN3184958Medicaid
TN3184950Medicaid
TN4142820OtherBCBS
TN31849501Medicare PIN
D32157Medicare UPIN