Tatum, Clifton

Tatum, Clifton is an individual health care provider with primary practice located at 200 E Gray St , Louisville KY 40202-2012. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Tatum, Clifton can be contacted via phone (502) 629-7601.

Contact Information

Primary practice address
200 E Gray St Louisville KY 40202-2012
Phone: (502) 629-7601
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 26863 Kentucky

Profile Details

NPI number 1366440687
LBN Legal business name Tatum, Clifton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Jan 25th, 2013 - about 13 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 1366440687 NPPES
Indiana MEDICAID 100356810A
Indiana Other 1052796
Indiana Other 50005985
Indiana MEDICAID 64268634
Indiana Other 000000308613
Indiana Other 000000050041

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