Marvin Dementreous Clifton, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

05469R Issued in LA

Practice address

4884 Constitution Ave
Ste 1E
Baton Rouge, LA 70808-3324

Phone

(225) 923-1621

Fax

(225) 923-1623

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255423992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4884 CONSTITUTION AVE",
            "address_2": "STE 1E",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708083324",
            "telephone_number": "225-923-1621",
            "fax_number": "225-923-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4884 CONSTITUTION AVE",
            "address_2": "STE 1E",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708083324",
            "telephone_number": "225-923-1621",
            "fax_number": "225-923-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "MARVIN",
        "middle_name": "DEMENTREOUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "LA",
            "license": "05469R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Clesi, LCSW
• Heather A Clesi
• Valorie Cleveland
• John R Clifford, MD
• Carey Clifton, DPM
• Jama Cline
• Clinic of Ear Nose Throat & Neck
• Linda D Clopton
• Dusti L Clouatre, P.T.
• Margot Cloutier, LCSW

• Neurological Surgery Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Neurological Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.