Tatum, Clifton
Tatum, Clifton is an individual health care provider with primary practice located at 200 E Gray St , Louisville KY 40202-2012. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Tatum, Clifton can be contacted via phone (502) 629-7601.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 26863 | Kentucky |
Profile Details
NPI number | 1366440687 |
---|---|
LBN Legal business name | Tatum, Clifton |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 11th, 2005 |
Last updated | Jan 25th, 2013 - about 11 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 | 1366440687 | NPPES |
Indiana | MEDICAID | 100356810A | |
Indiana | Other | 1052796 | |
Indiana | Other | 50005985 | |
Indiana | MEDICAID | 64268634 | |
Indiana | Other | 000000308613 | |
Indiana | Other | 000000050041 |
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