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Individual

JOHN R CLEMENTS

Active
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Individual

JOHN R CLEMENTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103300956
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629012208
VIRGINIA HEALTH NETWORK
VA
05
—
1629012208
—
VA
01
—
371194700
BLACK LUNG
VA
01
—
3810011217
MEDICAID OF WEST VIRGINIA
VA
01
—
540506332108
TRICARE
VA
01
—
P00403951
RAILROAD MEDICARE
VA
Enumeration date
06/15/2006
Last updated
03/21/2014
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