Vanlandingham, Clint L

Vanlandingham, Clint L is an sole proprietor health care provider with primary practice located at 2600 Kanell Blvd , Poplar Bluff MO 63901-3001. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Vanlandingham, Clint L can be contacted via phone (573) 785-4546.

Contact Information

Primary practice address
2600 Kanell Blvd Poplar Bluff MO 63901-3001
Phone: (573) 785-4546
Fax: (573) 785-6959
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2014037662 Missouri
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 2004001321 Missouri
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 2004001321 Missouri

Profile Details

NPI number 1508838566
LBN Legal business name Vanlandingham, Clint L
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 3rd, 2006
Last updated Jan 27th, 2020 - about 6 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 1508838566 NPPES
Missouri MEDICAID 309166510

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