Provider Demographics
NPI:1922256783
Name:CLARKSVILLE INTERNAL MEDICINE, PLC
Entity Type:Organization
Organization Name:CLARKSVILLE INTERNAL MEDICINE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARATKUMAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-648-7615
Mailing Address - Street 1:111 CENTER POINTE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-8682
Mailing Address - Country:US
Mailing Address - Phone:931-648-7615
Mailing Address - Fax:931-648-7616
Practice Address - Street 1:111 CENTER POINTE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-8682
Practice Address - Country:US
Practice Address - Phone:931-648-7615
Practice Address - Fax:931-648-7616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26865207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3096435Medicaid
TN3096435Medicare PIN
TNG17710Medicare UPIN