Healthcare Provider Details

I. General information

NPI: 1366982779
Provider Name (Legal Business Name): CLINT ANDREW BADGER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2017
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1671 CROOKED OAK DR
LANCASTER PA
17601-4269
US

IV. Provider business mailing address

1671 CROOKED OAK DR
LANCASTER PA
17601-4269
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-5331
  • Fax: 717-569-4210
Mailing address:
  • Phone: 717-569-5331
  • Fax: 717-569-4210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberOS022773
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: