Provider Demographics
NPI:1053650630
Name:OJO, CLARENCE O (MD)
Entity Type:Individual
Prefix:MR
First Name:CLARENCE
Middle Name:O
Last Name:OJO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 6TH AVE. N.
Mailing Address - Street 2:
Mailing Address - City:ST. CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2735
Mailing Address - Country:US
Mailing Address - Phone:320-252-3342
Mailing Address - Fax:320-252-3501
Practice Address - Street 1:1200 6TH AVE. N.
Practice Address - Street 2:
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2735
Practice Address - Country:US
Practice Address - Phone:320-252-3342
Practice Address - Fax:320-252-3501
Is Sole Proprietor?:No
Enumeration Date:2013-02-02
Last Update Date:2018-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN637322086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery