Provider Demographics
NPI:1457442840
Name:ARCENEAUX, CLIFF WALKER (PA-C)
Entity Type:Individual
Prefix:
First Name:CLIFF
Middle Name:WALKER
Last Name:ARCENEAUX
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 COUNTY ROAD 52
Mailing Address - Street 2:
Mailing Address - City:JEMISON
Mailing Address - State:AL
Mailing Address - Zip Code:35085-5068
Mailing Address - Country:US
Mailing Address - Phone:205-245-3422
Mailing Address - Fax:
Practice Address - Street 1:1 W LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-0500
Practice Address - Country:US
Practice Address - Phone:205-916-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA-473363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant