# CLINTON A NETHERLAND, MD APMC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CLINTON A NETHERLAND, MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902089246
- **Authorized official:** DR. CLINTON A NETHERLAND MD (PRESIDENT)
- **Authorized official phone:** (318) 556-3333

## Contact information

- **Practice address:** 510 S WASHINGTON ST, BASTROP, LA 71220-5033
- **Practice address phone:** (318) 556-3333
- **Practice address fax:** (318) 283-5141
- **Mailing address:** 510 S WASHINGTON ST, BASTROP, LA 71220-5033
- **Mailing address phone:** (318) 556-3333
- **Mailing address fax:** (318) 283-5141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/10/2007
- **Last updated:** 12/10/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1104108 | — | LA |