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General NPI Number Information
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NPI Number | 1730372533
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Entity Type | Individual
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Provider Name | CARL B CLEMENTS PH. D
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Gender | Male
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 08/24/2007
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Provider Practice Location Address
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Address Line | 3701 LOOP RD BLDG 39
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5015
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Country | US
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Telephone | 205-562-3700
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Fax | 205-562-3769
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Provider Business Mailing Address
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Address Line | PO BOX 870348
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City | TUSCALOOSA
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State | AL
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Zip | 35487-0001
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Country | US
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Telephone | 205-348-9694
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Fax | 205-348-8648
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 142
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License Number State | AL
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