Robert C. Clingan, MD, Dermatology

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

13005 Issued in MS

Legal business name

ROBERT C. CLINGAN, MD, DERMATOLOGY

Practice address

2080 S Frontage Rd
Suite 113
Vicksburg, MS 39180-5328

Phone

(601) 636-1658

Fax

(601) 636-1076

NPI assigned

Nov 27, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert C Clingan, M.D.

Title

Owner/Physician

Phone

(601) 636-1658

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1448582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448582400000",
    "number": "1134593361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 S FRONTAGE RD",
            "address_2": "SUITE 113",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805328",
            "telephone_number": "601-636-1658",
            "fax_number": "601-636-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 S FRONTAGE RD",
            "address_2": "SUITE 113",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805328",
            "telephone_number": "601-636-1658",
            "fax_number": "601-636-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT C. CLINGAN, MD, DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-27",
        "last_updated": "2015-11-27",
        "status": "A",
        "authorized_official_last_name": "CLINGAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "601-636-1658",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MS",
            "license": "13005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02258379",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Robert a. Sadler DDS, PA
• Robert C Masterson DO PA Inc
• Robert M Abraham, D.D.S., P.a.
• Robert M Cannon MD LLC
• James Roberts
• Maggie Brittany Roberts
• Kristy G Robertson, P-LPC

• Medical Specialty Clinic/Center in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Medical Specialty Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.