Provider Demographics
NPI:1144433376
Name:JOHN K. ENDSLEY, MD, PC
Entity type:Organization
Organization Name:JOHN K. ENDSLEY, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ENDSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-245-2090
Mailing Address - Street 1:311 LANDRUM PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6319
Mailing Address - Country:US
Mailing Address - Phone:931-245-2090
Mailing Address - Fax:931-245-2091
Practice Address - Street 1:311 LANDRUM PL
Practice Address - Street 2:SUITE 100
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6319
Practice Address - Country:US
Practice Address - Phone:931-245-2090
Practice Address - Fax:931-245-2091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN023560207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty