# CLINTON H. SHARP, III, M.D

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

## Provider details

- **NPI number:** 1245360882
- **Authorized official:** DR. CLINTON HARRY SHARP III M.D. (OWNER)
- **Authorized official phone:** (985) 641-8191

## Contact information

- **Practice address:** 1051 GAUSE BLVD, SUITE 380, SLIDELL, LA 70458-2951
- **Practice address phone:** (985) 641-8191
- **Practice address fax:** (985) 641-9812
- **Mailing address:** 1051 GAUSE BLVD, SUITE 380, SLIDELL, LA 70458-2951
- **Mailing address phone:** (985) 641-8191
- **Mailing address fax:** (985) 641-9812

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD.016693 | LA | Yes |

## Other

- **Enumeration date:** 03/06/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1386405 | — | LA |