| Clifton W. Salmon, M.d. | |
|
104 Morris Cir Homer LA 71040-2100 | |
| (318) 927-6777 | |
| (318) 927-6714 |
| Full Name | Clifton W. Salmon, M.d. |
|---|---|
| Speciality | Family Medicine |
| Location | 104 Morris Cir, Homer, Louisiana |
| Authorized Official Name and Position | Clifton Wales Salmon (OWNER) |
| Authorized Official Contact | 3189276777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clifton W. Salmon, M.d. Po Box 300 104 Morris Circle Homer LA 71040-0300 Ph: (318) 927-6777 | Clifton W. Salmon, M.d. 104 Morris Cir Homer LA 71040-2100 Ph: (318) 927-6777 |
| NPI Number | 1033175906 |
|---|---|
| Provider Enumeration Date | 04/21/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2163474321 |
|---|---|
| Medicare Enrollment ID | O20050216000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033175906 | NPI | - | NPPES |
| 1443620 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 018524 (Louisiana) | Primary |
| Provider Name | Camille T Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013949213 PECOS PAC ID: 0345273090 Enrollment ID: I20050914000342 |
| Provider Name | Clifton Wales Salmon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346205507 PECOS PAC ID: 4486790490 Enrollment ID: I20100726000247 |
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