Individual
DR. EMMETTE ROSS CLIFTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
345 HEALTHWEST DR, DOTHAN, AL 36303-2053
(334) 793-2663
(334) 836-2248
Mailing address
PO BOX 729, DOTHAN, AL 36302-0729
(334) 793-2663
(334) 836-2248
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
DO 319
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000532364D
—
GA
05
—
000532364E
—
GA
01
—
1306891593
MEDICARE ID
AL
05
—
159086
—
AL
05
—
159704
—
AL
05
—
164246
—
AL
01
—
511-47106
BCBS OF AL - HEALTHWEST
AL
01
—
511-47107
BCBS OF AL - RCC
AL
01
—
511-52694
BCBS OF AL - ENTERPRISE
AL
Enumeration date
05/24/2006
Last updated
03/04/2015
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