Clanton, Jesse E
Clanton, Jesse E is an individual health care provider with primary practice located at 2302 College Ave , Conway AR 72034-6297. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Clanton, Jesse E can be contacted via phone (501) 513-5793.Contact Information
Primary practice address
2302 College Ave
Conway AR 72034-6297
Phone: (501) 513-5793
Fax: (501) 513-5417
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | C5274 | Arkansas |
Profile Details
| NPI number | 1033106505 |
|---|---|
| LBN Legal business name | Clanton, Jesse E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Jul 29th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033106505 | NPPES |
| Arkansas | MEDICAID | 104705001 |
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