# ROBERT C. CLINGAN, MD, DERMATOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134593361
- **Authorized official:** DR. ROBERT C CLINGAN M.D. (OWNER/PHYSICIAN)
- **Authorized official phone:** (601) 636-1658

## Contact information

- **Practice address:** 2080 S FRONTAGE RD, SUITE 113, VICKSBURG, MS 39180-5328
- **Practice address phone:** (601) 636-1658
- **Practice address fax:** (601) 636-1076
- **Mailing address:** 2080 S FRONTAGE RD, SUITE 113, VICKSBURG, MS 39180-5328
- **Mailing address phone:** (601) 636-1658
- **Mailing address fax:** (601) 636-1076

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 13005 | MS | Yes |

## Other

- **Enumeration date:** 11/27/2015
- **Last updated:** 11/27/2015