Healthcare Provider Details

I. General information

NPI: 1952368185
Provider Name (Legal Business Name): HOWARD L. CLINTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 MIMOSA DR
ASHEVILLE NC
28806-1719
US

IV. Provider business mailing address

136 MIMOSA DR
ASHEVILLE NC
28806-1719
US

V. Phone/Fax

Practice location:
  • Phone: 828-281-8131
  • Fax: 828-281-8177
Mailing address:
  • Phone: 828-281-8131
  • Fax: 828-281-8177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number22098
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: