Provider Demographics
NPI:1326034398
Name:CLARY FOOTE MD PC
Entity Type:Organization
Organization Name:CLARY FOOTE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CLARY
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:FOOTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-882-2800
Mailing Address - Street 1:2319 S ROANE ST
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-8653
Mailing Address - Country:US
Mailing Address - Phone:865-882-2800
Mailing Address - Fax:865-882-3512
Practice Address - Street 1:2319 S ROANE ST
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8653
Practice Address - Country:US
Practice Address - Phone:865-882-2800
Practice Address - Fax:865-882-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3850330Medicare ID - Type Unspecified