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General NPI Number Information
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NPI Number | 1699068395
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Entity Type | Individual
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Provider Name | DANIEL PHILLIP CLEMENTS PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/27/2011
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 149 COMMONS DR
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City | MARTIN
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State | TN
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Zip | 38237-3882
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Country | US
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Telephone | 731-422-0213
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Fax | 731-506-1863
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Provider Business Mailing Address
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Address Line | PO BOX 400
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City | JACKSON
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State | TN
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Zip | 38302-0400
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Country | US
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Telephone | 731-423-8697
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Fax | 731-256-7634
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1983
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1983
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License Number State | TN
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