Organization
ROBERT C. CLINGAN, MD, DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT C CLINGAN M.D. (OWNER/PHYSICIAN)
(601) 636-1658
Entity
Organization
Contact information
Practice address
2080 S FRONTAGE RD, SUITE 113, VICKSBURG, MS 39180-5328
(601) 636-1658
(601) 636-1076
Mailing address
2080 S FRONTAGE RD, SUITE 113, VICKSBURG, MS 39180-5328
(601) 636-1658
(601) 636-1076
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
13005
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02258379
—
MS
Enumeration date
11/27/2015
Last updated
11/27/2015
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