Provider Demographics
NPI:1972742120
Name:CLIPPERTON, JOEL A (R EEG T, CLTM)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:A
Last Name:CLIPPERTON
Suffix:
Gender:M
Credentials:R EEG T, CLTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
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Mailing Address - Street 1:7557 E WARREN CIR APT 5-108
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5346
Mailing Address - Country:US
Mailing Address - Phone:949-238-4887
Mailing Address - Fax:
Practice Address - Street 1:7557 E WARREN CIR APT 5-108
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5346
Practice Address - Country:US
Practice Address - Phone:949-238-4887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL4505246ZE0500X, 246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG