Provider Demographics
NPI:1073513941
Name:MCLEMORE, CARL EUGENE JR (MD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:EUGENE
Last Name:MCLEMORE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-526-0011
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:310 DUREL DR
Practice Address - Street 2:
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760-2973
Practice Address - Country:US
Practice Address - Phone:225-713-2400
Practice Address - Fax:225-713-2405
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2021-02-19
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Provider Licenses
StateLicense IDTaxonomies
LA013318207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA193857OtherMEDICARE GROUP # FOR RURAL HEALTH
LA080186474OtherRAILROAD MEDICARE
LA1184659Medicaid
LA53741D279Medicare PIN
LA080186474OtherRAILROAD MEDICARE