Roy Dale Clemens, M.D.

Individual provider Active NPI Family Medicine Physician · Siloam Springs, AR

NPI 1992755367 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1992755367
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
C5385 (AR)
Practice address
451 S Holly St
Siloam Springs, AR 72761-3018
Phone
(479) 524-3141
Fax
(479) 524-3090
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C5385ARMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C5385 AR Yes

Addresses

Primary practice location

451 S Holly St
Siloam Springs, AR 72761-3018

Mailing address

451 S Holly St
Siloam Springs, AR 72761-3018
Phone (479) 524-3141

Other identifiers

IdentifierTypeStateIssuer
51059OtherARBCBS AR

Other names

  • R Dale Clemens Other name

Other providers in Siloam Springs, AR

All providers in Siloam Springs, AR · Family Medicine Physician in Arkansas

Sources for this page

Verify at the official NPI Registry.