Healthcare Provider Details

I. General information

NPI: 1972998540
Provider Name (Legal Business Name): CLIFTON CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 N SNEAD ST
BOAZ AL
35957-1763
US

IV. Provider business mailing address

PO BOX 720
BOAZ AL
35957-0720
US

V. Phone/Fax

Practice location:
  • Phone: 256-840-5800
  • Fax: 256-840-5600
Mailing address:
  • Phone: 256-840-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25564
License Number StateAL

VIII. Authorized Official

Name: DR. ANGELA CLIFTON
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 256-840-5800