Provider Demographics
NPI:1770580052
Name:CALARCO, MARK (DO, MBA)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:CALARCO
Suffix:
Gender:M
Credentials:DO, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3409
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37024-3409
Mailing Address - Country:US
Mailing Address - Phone:615-732-6170
Mailing Address - Fax:888-357-6695
Practice Address - Street 1:725 COOL SPRINGS BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2702
Practice Address - Country:US
Practice Address - Phone:615-732-6170
Practice Address - Fax:888-357-6695
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO1613173000000X
TNDO00000016132083T0002X, 207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical Toxicology
No173000000XOther Service ProvidersLegal Medicine
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4278308OtherBCBS OF TN
TN103I082994Medicare PIN
TN4278308OtherBCBS OF TN
TNE95122Medicare UPIN
TN103I084381Medicare PIN
TN103I184708Medicare PIN
TN103I084380Medicare PIN