Provider Demographics
NPI:1700862505
Name:CLEM, WILLIAM BARNARD III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BARNARD
Last Name:CLEM
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 260155
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80163-0155
Mailing Address - Country:US
Mailing Address - Phone:303-471-1634
Mailing Address - Fax:720-344-5586
Practice Address - Street 1:1719 E 19TH AVE
Practice Address - Street 2:HYPERBARIC MEDICINE CENTER, P/SL MEDICAL CENTER
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218
Practice Address - Country:US
Practice Address - Phone:303-839-6900
Practice Address - Fax:303-839-6157
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO29361207P00000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Not Answered2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04004891Medicaid
COB3828Medicare ID - Type Unspecified
COC03965Medicare UPIN