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Individual
JOHN LARRY CLEMENTS
Active
Individual
JOHN LARRY 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
0103000391
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710920632
AETNA
VA
05
—
1710920632
—
VA
01
—
540506332085
TRICARE/CHAMPUS
VA
01
—
P00624452
RAILROAD MEDICARE
VA
Enumeration date
06/14/2006
Last updated
03/11/2014
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