Individual
CLINTON SLOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9816
(304) 757-6999
(304) 757-3252
Mailing address
301 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9552
(304) 757-6999
(304) 757-3252
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
820
WV
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
820
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00427037
RR MEDICARE
WV
05
—
0074222000
—
WV
05
—
0528227
—
OH
05
—
64107527
—
KY
Enumeration date
04/19/2006
Last updated
11/15/2018
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