Individual
DR. CLINTON HARRY SHARP III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1051 GAUSE BLVD, SUITE 380, SLIDELL, LA 70458-2951
(985) 641-8191
(985) 641-9812
Mailing address
1051 GAUSE BLVD, SUITE 380, SLIDELL, LA 70458-2951
(985) 641-8191
(985) 641-9812
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11192
MS
207Q00000X
Family Medicine Physician
Primary
16693
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08205520
—
MS
05
—
1386405
—
LA
Enumeration date
10/17/2005
Last updated
07/09/2007
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