Provider Demographics
NPI:1467196618
Name:CLINGAN, WILLIAM
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:CLINGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:QUINWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:25981-0072
Mailing Address - Country:US
Mailing Address - Phone:681-291-3066
Mailing Address - Fax:
Practice Address - Street 1:205 CRICHTON AVE
Practice Address - Street 2:
Practice Address - City:CRICHTON
Practice Address - State:WV
Practice Address - Zip Code:25981-1102
Practice Address - Country:US
Practice Address - Phone:681-291-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant