Provider Demographics
NPI:1548254261
Name:CLEMENTS, JOEL B IX (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:B
Last Name:CLEMENTS
Suffix:IX
Gender:M
Credentials:MD
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Mailing Address - Street 1:979 E 3RD ST
Mailing Address - Street 2:STE 300
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2136
Mailing Address - Country:US
Mailing Address - Phone:423-267-0466
Mailing Address - Fax:423-493-2395
Practice Address - Street 1:2108 E 3RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2600
Practice Address - Country:US
Practice Address - Phone:423-267-0466
Practice Address - Fax:423-493-2395
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2015-02-11
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Provider Licenses
StateLicense IDTaxonomies
TNMD6312174400000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2006413OtherBCBS OF TN
TN3158173Medicaid
020041617OtherRR MEDICARE
1740069OtherUHC
GA00063269AMedicaid
62165877414OtherJDH
AL009933930Medicaid
NC890658YMedicaid
GA00063269AMedicaid
TN3158173Medicaid
NC890658YMedicaid