Basic Information
| Provider Information | |||||||||
| NPI: | 1316943665 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EVERHART | ||||||||
| FirstName: | CLYDE | ||||||||
| MiddleName: | HUGH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 GLENWOOD DR | ||||||||
| Address2: | SUITE E-500 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374041163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234952635 | ||||||||
| FaxNumber: | 4234952638 | ||||||||
| Practice Location | |||||||||
| Address1: | 725 GLENWOOD DR | ||||||||
| Address2: | SUITE E-500 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374041163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234952635 | ||||||||
| FaxNumber: | 4234952638 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2005 | ||||||||
| LastUpdateDate: | 07/24/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 43764 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.