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General NPI Number Information
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NPI Number | 1053348037
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Entity Type | Individual
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Provider Name | CLINT DANIEL KINGSLEY MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 180 COX CREEK PKWY S STE B
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City | FLORENCE
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State | AL
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Zip | 35630-3263
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Country | US
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Telephone | 256-760-0422
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18428
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City | HUNTSVILLE
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State | AL
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Zip | 35804-8428
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Country | US
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Telephone | 256-705-4224
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Fax | 256-705-4135
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 49477
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 25035
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License Number State | AL
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