Individual
TERRY A CLINKENBEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
200 HIGHWAY 2 W, DEVILS LAKE, ND 58301-3532
(701) 665-2200
(701) 665-2300
Mailing address
PO BOX 650, DEVILS LAKE, ND 58301-0650
(701) 665-2200
(701) 665-2300
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5449
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000481
BCBS PIN
ND
05
—
054518
—
ND
01
—
260035844
RR MEDICARE ID
ND
Enumeration date
06/16/2006
Last updated
01/24/2012
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