Provider Demographics
NPI:1033303102
Name:CLINGAN, WARREN JEFFERSON III (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:JEFFERSON
Last Name:CLINGAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WREN
Other - Middle Name:
Other - Last Name:CLINGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:924 MONTCLAIR RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1200
Mailing Address - Country:US
Mailing Address - Phone:205-591-7999
Mailing Address - Fax:205-591-5051
Practice Address - Street 1:924 MONTCLAIR RD STE 200
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1200
Practice Address - Country:US
Practice Address - Phone:205-591-7999
Practice Address - Fax:205-591-5051
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5373207ZP0102X
AL29831207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1568516151Medicaid
AR168511001Medicaid
AL1568516151Medicaid