Candace Renee Clocker in South Boston - Primary Care
Candace Renee Clocker - NPI 1841488905
Candace Renee Clocker is a Primary Care in South Boston, Virginia. Candace Renee Clocker practices all healthcare services and medical treatments related to Primary Care. The NPI Number for Candace Renee Clocker is 1841488905. The last update date is 2020-11-23.
Candace Renee Clocker's current location address is 2100 Wilborn Ave, South Boston, Virginia. You can contact this provider via phone number 4345178022 and fax number 4345178370. The mailing address for Candace Renee Clocker is 2100 Wilborn Ave, South Boston, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Candace Renee Clocker |
|---|---|
| Address | 2100 Wilborn Ave, South Boston, Virginia |
| Phone Number | 4345178022 |
| Fax Number | 4345178370 |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1841488905 |
|---|---|
| Provider Enumeration Date | 2007-10-12 |
| Last Updated Date | 2020-11-23 |
Provider Mailing Address Detail
| Address | 2100 Wilborn Ave |
|---|---|
| City | South Boston |
| State | Virginia (VA) |
| Post Code | 245921628 |
| Phone Number | 4345178022 |
| Fax Number | 4345178370 |
Provider's Primary Taxonomy Detail
| Speciality | Primary Care |
|---|---|
| Taxonomy | 261Qp2300X |
| Licence No | 33110 |
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Definition: Serves as the first point of contact for comprehensive healthcare services. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 33110 | SC | LICENSE NUMBER |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Candace Renee Clocker by the Centers for Medicare & Medicaid Services?
The Candace Renee Clocker has been assigned the NPI (National Provider Identifier) 1841488905 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Candace Renee Clocker is located?
The Candace Renee Clocker is situated at the following address: 2100 Wilborn Ave, South Boston, VA, 245921628.
What is Candace Renee Clocker's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Candace Renee Clocker is Primary Care, and the taxonomy classification code that categorizes this area of expertise is 261Qp2300X.
On what date did the Centers for Medicare & Medicaid Services issue the 1841488905 to Candace Renee Clocker?
The Candace Renee Clocker received its 1841488905 assignment from the Centers for Medicare & Medicaid Services on 2007-10-12.
When was the information related to Candace Renee Clocker most recently updated or refreshed?
The details pertaining to the Candace Renee Clocker, including its address, specialty, and other relevant information, were last updated or refreshed on 2020-11-23.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC