Provider Demographics
NPI:1255597613
Name:CLEMMONS, ROGER MAYEDA (DVM, PHD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:MAYEDA
Last Name:CLEMMONS
Suffix:
Gender:M
Credentials:DVM, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8718 SW 42ND PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4147
Mailing Address - Country:US
Mailing Address - Phone:352-328-1794
Mailing Address - Fax:
Practice Address - Street 1:2015 SW 16TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1166
Practice Address - Country:US
Practice Address - Phone:352-328-1794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLVM2707174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian