Provider Demographics
NPI:1427019371
Name:CLEMENTS, HERMAN RONALD II (MD)
Entity type:Individual
Prefix:
First Name:HERMAN
Middle Name:RONALD
Last Name:CLEMENTS
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 S POPLAR ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6017
Mailing Address - Country:US
Mailing Address - Phone:501-279-7600
Mailing Address - Fax:501-279-7605
Practice Address - Street 1:403 S POPLAR ST
Practice Address - Street 2:SUITE C
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6017
Practice Address - Country:US
Practice Address - Phone:501-279-7600
Practice Address - Fax:501-279-7605
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG872512084P0800X
ARE55502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE5550OtherSTATE LICENSE
BC4650330OtherDEA
AR5H262G245Medicare PIN
AR5G245Medicare PIN
G62282Medicare UPIN