Clement, Kevin Bryan

Clement, Kevin Bryan is an individual health care provider with primary practice located at 415 S 28Th Ave , Hattiesburg MS 39401-7246. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Clement, Kevin Bryan can be contacted via phone (601) 268-5630.

Contact Information

Primary practice address
415 S 28Th Ave Hattiesburg MS 39401-7246
Phone: (601) 268-5630
Fax: (601) 268-5819
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 00022961 Alabama
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 16905 Mississippi

Profile Details

NPI number 1578509725
LBN Legal business name Clement, Kevin Bryan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jul 2nd, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578509725 NPPES
Mississippi MEDICAID 00123076
Mississippi Other 5750556
Mississippi Other 1353817
Mississippi MEDICAID 009935563

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