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General NPI Number Information
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NPI Number | 1942812334
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Entity Type | Individual
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Provider Name | MANACEY CLERMONT PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 7125 E CESAR CHAVEZ BLVD
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City | YUMA
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State | AZ
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Zip | 85349
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Country | US
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Telephone | 928-627-8871
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Fax |
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Provider Business Mailing Address
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Address Line | 7125 E CESAR CHAVEZ BLVD
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City | SAN LUIS
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State | AZ
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Zip | 85349
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Country | US
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Telephone | 928-627-8871
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 8534
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License Number State | AZ
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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 | PACN63
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 000682-P.A.
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License Number State | PR
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-11839
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 036933
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | CV21021471021
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License Number State | IN
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Taxonomy #7
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | EL07785
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License Number State | NH
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