Individual
PHILIP CARLISLE CLEMENTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
585 NEW LONDON RD, LATHAM, NY 12110-5701
(518) 783-1472
(518) 783-1605
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
171241
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01698282
—
NY
Enumeration date
11/16/2006
Last updated
05/12/2021
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