Doctor Name: | JEFFREY CLEMENS |
NPI Number: | 1912984865 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 32991 |
Business Practice Address: | 3601 Sw 160th Ave Suite 250 Miramar, FL - 330276308 |
Business Phone Number: | 8778667123 |
Business Fax Number: | |
Mailing Address: | 2920 Phoenix Pt, COLORADO SPRINGS |
State: | CO |
Postal Code: | 809066731 |
Phone Number: | 7193519587 |
Fax Number: | 7194771106 |
NPI Enumeration Date: | 12/30/2005 |
NPI Last Update Date: | 10/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 32991 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |