| NPI | 1598160822 |
|---|---|
| Doing Business As | CLINTON MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | LYNNE CHRISTINE FISCUS Cmo 984-215-4111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2019-08-14 |