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NPI Code Detail

MEDICARE: GREGORY PAUL CLIFFORD M.D.

MEDICARE: GREGORY PAUL CLIFFORD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician5956AWY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023006533
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY PAUL CLIFFORD M.D.
Provider Business Mailing Address
First Line : PO BOX 678898
Second Line :
City : DALLAS
State : TX
Zip : 75267-8898
Country : US
Telephone Number : 801-423-3306
Fax Number : 719-591-2745
Provider Business Practice Location Address
First Line : 1320 BISHOP RANDALL DR
Second Line :
City : LANDER
State : WY
Zip : 82520-3939
Country : US
Telephone Number : 307-335-6365
Fax Number : 307-332-0312
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2005
Last Update Date : 10/26/2015

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