Clemson, Barry S

Clemson, Barry S is an individual health care provider with primary practice located at 5405 N Knoxville Ave , Peoria IL 61614-5016. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Clemson, Barry S can be contacted via phone (309) 691-4410.

Contact Information

Primary practice address
5405 N Knoxville Ave Peoria IL 61614-5016
Phone: (309) 691-4410
Fax: (309) 692-4730
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X MD031862E Pennsylvania
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 036086030 Illinois
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036086030 Illinois

Profile Details

NPI number 1942234323
LBN Legal business name Clemson, Barry S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Jan 8th, 2024 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942234323 NPPES
Illinois MEDICAID 036086030

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