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DOUGLAS MARLEY CLARK PAC
NPI 1487682498
Physician Assistant - Medical in Harriman, TN

Active since June 29, 2006
2317 S ROANE ST, COMMUNITY CARE WALK IN CLINIC, HARRIMAN, TN 37748(865) 590-0072(865) 590-0069 Get Directions Write a Review

NPPES record last updated: February 15, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Douglas Marley Clark Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOUGLAS MARLEY CLARK PAC (NPI 1487682498) is an individual medical provider in Harriman, Tennessee, licensed in Tennessee (PA000000019) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1487682498
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameDOUGLAS MARLEY CLARKCredential: PAC
Location Address2317 S ROANE ST, COMMUNITY CARE WALK IN CLINICHarriman, TN 37748-8653
Mailing Address2317 S Roane StHarriman, TN 37748-8653 · (865) 590-0072 · Fax (865) 590-0069
Phone(865) 590-0072
Fax(865) 590-0069
Sole ProprietorNo
Enumeration DateJune 29, 2006
Last NPPES UpdateFebruary 15, 2012
✔ NPI 1487682498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in TN · PA000000019
2317 S ROANE ST, Harriman, TN 37748
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Other Identifiers 3

Medicare UPINR93277
Medicaid3723702TN
Medicare ID-Type Unspecified3665184TN

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLEE MARIE LOY CPNP-PC
Nurse Practitioner (Pediatrics)
2317 S ROANE ST
HARRIMAN, TN 37748
Roane County (865) 285-9721
DR. THOMAS LEE PRITCHARD JR. DDS
Dentist (General Practice)
2317 S ROANE ST
HARRIMAN, TN 37748
Roane County (865) 882-2252
KIDZCARE PEDIATRICS, PLLC
Clinic/Center (Rural Health)
2317 S ROANE ST
HARRIMAN, TN 37748
Roane County (423) 745-7500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Clark's NPI number?

The NPI number for Douglas Clark is 1487682498. It was assigned to this individual provider in the NPPES registry on June 29, 2006.

Where is Douglas Clark located?

Douglas Clark practices at 2317 S Roane St Community Care Walk In Clinic, Harriman, TN 37748. The listed phone number is (865) 590-0072.

What is Douglas Clark's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Douglas Clark was last updated on February 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.