Provider Demographics
NPI:1437327327
Name:BARTON M CLEMENTS MD
Entity type:Organization
Organization Name:BARTON M CLEMENTS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARTON
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-823-4045
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-0099
Mailing Address - Country:US
Mailing Address - Phone:931-823-4045
Mailing Address - Fax:931-823-4059
Practice Address - Street 1:502 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-1718
Practice Address - Country:US
Practice Address - Phone:931-823-4045
Practice Address - Fax:931-823-4059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18004208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1504317Medicaid
TNF26551Medicare UPIN
TN30675251Medicare PIN
TN1504317Medicaid