Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101035645 | VA |
N | 111NI0900X | Internist | 0101035645 | VA |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 0101035645 | VA |
NPI | 1023108669 |
---|---|
Provider Name | Dr. John Newton Clore |
First Address | Lynchburg, VA 24501-1106 |
Second Address | Lynchburg, VA 24502-4272 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 30/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E38630 | (02) |