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General NPI Number Information
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NPI Number | 1437163763
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Entity Type | Individual
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Provider Name | CLINTON WASHINGTON MD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 60021 MONROE ST
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City | SMITHVILLE
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State | MS
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Zip | 38870-7779
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Country | US
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Telephone | 662-651-4637
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Fax |
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Provider Business Mailing Address
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Address Line | 404 GILMORE DR
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City | AMORY
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State | MS
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Zip | 38821-5414
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Country | US
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Telephone | 662-256-3564
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 14904
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License Number State | MS
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