Provider Demographics
NPI:1437561149
Name:CLOUGH, NICHOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:CLOUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5751 BRADFORD HICKS DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-2237
Mailing Address - Country:US
Mailing Address - Phone:931-823-3030
Mailing Address - Fax:931-823-3018
Practice Address - Street 1:5751 BRADFORD HICKS DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-2237
Practice Address - Country:US
Practice Address - Phone:931-823-3030
Practice Address - Fax:931-823-3018
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD55963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine