Provider Demographics
NPI:1326137472
Name:WILLIAM CLEVER
Entity Type:Organization
Organization Name:WILLIAM CLEVER
Other - Org Name:DBA APPALACHIAN FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLEVER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:423-282-4170
Mailing Address - Street 1:102 WEST SPRINGBROOK
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604
Mailing Address - Country:US
Mailing Address - Phone:423-282-4170
Mailing Address - Fax:423-282-4903
Practice Address - Street 1:102 WEST SPRINGBROOK
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604
Practice Address - Country:US
Practice Address - Phone:423-282-4170
Practice Address - Fax:423-282-4903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN08014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3642412Medicaid
TN3642412Medicaid