Provider Demographics
NPI:1386728780
Name:CLEMENTS, JAMES SIDNEY JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SIDNEY
Last Name:CLEMENTS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5120 BAYOU BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2135
Mailing Address - Country:US
Mailing Address - Phone:850-432-3692
Mailing Address - Fax:850-332-6445
Practice Address - Street 1:5120 BAYOU BLVD STE 11
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2135
Practice Address - Country:US
Practice Address - Phone:850-432-3692
Practice Address - Fax:850-332-6445
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2024-08-07
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Provider Licenses
StateLicense IDTaxonomies
FLME0054764207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009505730Medicaid
FL035962900Medicaid
08567ZMedicare PIN