Doctor Name: | JAMES ALLEN CLEMMONS |
NPI Number: | 1114041662 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME 46868 |
Business Practice Address: | 1376 Brickyard Rd Ste 1 Chipley, FL - 324286391 |
Business Phone Number: | 8506380678 |
Business Fax Number: | 8506380678 |
Mailing Address: | Po Box 741, CHIPLEY |
State: | FL |
Postal Code: | 324280741 |
Phone Number: | 8506380678 |
Fax Number: | 8506380678 |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 12/22/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME 46868 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |