Clemson, Barry S
Clemson, Barry S is an individual health care provider with primary practice located at 5405 N Knoxville Ave , Peoria IL 61614-5016. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Clemson, Barry S can be contacted via phone (309) 691-4410.Contact Information
Primary practice address
5405 N Knoxville Ave
Peoria IL 61614-5016
Phone: (309) 691-4410
Fax: (309) 692-4730
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036086030 | Illinois |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036086030 | Illinois |
Profile Details
| NPI number | 1942234323 |
|---|---|
| LBN Legal business name | Clemson, Barry S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2006 |
| Last updated | Jan 20th, 2025 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942234323 | NPPES |
| Illinois | MEDICAID | 036086030 |
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