Provider Demographics
NPI:1013092410
Name:CARDEN, RONALD ALLEN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ALLEN
Last Name:CARDEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 WILMA RUDOLPH BLVD.
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-8960
Mailing Address - Country:US
Mailing Address - Phone:931-645-1564
Mailing Address - Fax:931-645-3842
Practice Address - Street 1:2320 WILMA RUDOLPH BLVD.
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-8960
Practice Address - Country:US
Practice Address - Phone:931-645-1564
Practice Address - Fax:931-645-3842
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA2064363A00000X
1035413363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant