Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 17696 | AZ |
N | 207RP1001X | Pulmonary Disease | 17696 | AZ |
N | 207RS0012X | Sleep Medicine | 17696 | AZ |
NPI | 1013909365 |
---|---|
Provider Name | Neil C Clements JR. |
First Address | Tucson, AZ 85710-2156 |
Second Address | Tucson, AZ 85710-2156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 10/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
189771 | (05) | AZ |
F89334 | (02) |