Provider Demographics
NPI:1093866162
Name:CLIFTON, LARRY PAUL (MPAS)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:PAUL
Last Name:CLIFTON
Suffix:
Gender:M
Credentials:MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-6331
Mailing Address - Country:US
Mailing Address - Phone:325-704-5037
Mailing Address - Fax:
Practice Address - Street 1:3001 S 27TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6331
Practice Address - Country:US
Practice Address - Phone:325-704-5037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant