Kevin Bryan Clement in Hattiesburg - Sports Medicine
Kevin Bryan Clement - NPI 1578509725
Kevin Bryan Clement is a Sports Medicine in Hattiesburg, Mississippi. Kevin Bryan Clement practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Kevin Bryan Clement is 1578509725. The last update date is 2010-07-02.
Kevin Bryan Clement's current location address is 415 S 28th Ave, Hattiesburg, Mississippi. You can contact this provider via phone number 6012685630 and fax number 6012685819. The mailing address for Kevin Bryan Clement is 415 S 28th Ave, Hattiesburg, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin Bryan Clement |
|---|---|
| Address | 415 S 28th Ave, Hattiesburg, Mississippi |
| Phone Number | 6012685630 |
| Fax Number | 6012685819 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1578509725 |
|---|---|
| Provider Enumeration Date | 2006-06-22 |
| Last Updated Date | 2010-07-02 |
Provider Mailing Address Detail
| Address | 415 S 28th Ave |
|---|---|
| City | Hattiesburg |
| State | Mississippi (MS) |
| Post Code | 394017246 |
| Phone Number | 6012685630 |
| Fax Number | 6012685819 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Qs0010X |
| Licence No | 16905 |
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Definition: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 123076 | MS | -- | |
| 5750556 | MS | AETNA | |
| 1353817 | MS | CIGNA | |
| 9935563 | AL | -- |
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What is the unique 10-digit identifier code assigned to Kevin Bryan Clement by the Centers for Medicare & Medicaid Services?
The Kevin Bryan Clement has been issued the NPI (National Provider Identifier) 1578509725 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Kevin Bryan Clement located?
The Kevin Bryan Clement is located at 415 S 28Th Ave, Hattiesburg, MS 394017246.
What is Kevin Bryan Clement's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kevin Bryan Clement's area of specialization is Sports Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Qs0010X.
On what date did the Centers for Medicare & Medicaid Services assign the 1578509725 to Kevin Bryan Clement?
The Centers for Medicare & Medicaid Services assigned the 1578509725 to Kevin Bryan Clement on 2006-06-22.
When was the information regarding Kevin Bryan Clement most recently updated?
The details pertaining to the Kevin Bryan Clement, including its address, specialty, and other relevant information, were last refreshed on 2010-07-02.