Provider Demographics
NPI:1881969129
Name:SCHOOLFIELD, CLINT SUMBERA JR (MD)
Entity type:Individual
Prefix:
First Name:CLINT
Middle Name:SUMBERA
Last Name:SCHOOLFIELD
Suffix:JR
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 1:604 FERRIDAY CT
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-7803
Mailing Address - Country:US
Mailing Address - Phone:318-426-3925
Mailing Address - Fax:
Practice Address - Street 1:200 W ESPLANADE AVE STE 401
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065
Practice Address - Country:US
Practice Address - Phone:504-464-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD045086208600000X
390200000X
LA308554208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program