Provider Demographics
NPI:1770651440
Name:CLINGMAN, JEFFREY A (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:CLINGMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MAPLE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03249-6580
Mailing Address - Country:US
Mailing Address - Phone:603-528-9100
Mailing Address - Fax:603-524-5743
Practice Address - Street 1:14 MAPLE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:GILFORD
Practice Address - State:NH
Practice Address - Zip Code:03249-6580
Practice Address - Country:US
Practice Address - Phone:603-528-9100
Practice Address - Fax:603-524-5743
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8510207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30004328Medicaid
NHRE1696Medicare ID - Type Unspecified
NH30004328Medicaid