MR. CLINTON BARRETT WALLIS (NPI# 1053359208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053359208 |
| Entity Type | Individual |
| Full Name | MR. CLINTON BARRETT WALLIS |
| Credential | O.T. |
| Practice Address |
709 Downtowner Loop W Mobile AL 36609-5503 |
| Practice Telephone | 2513801111 |
| Practice Fax Number | 2513801110 |
| Mailing Telephone | 2513801111 |
| Mailing Fax Number | 2513801110 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 2224 | AL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BCBS PROVIDER NUMBER | 51514463 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255384483 | Clinton Graves Wallis | Internal Medicine | 3366 Nw Expressway, Suite 400, Oklahoma City, OK 73112-4462 | 2006-05-18 |
| Street Address |
709 DOWNTOWNER LOOP W |
| City | MOBILE |
| State | AL |
| Zip Code | 36609-5503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447298708 | Robert L. Fleming II | Specialist | 709 Downtowner Loop W, Mobile, AL 36609-5503 | 2006-06-02 |
| 1134657489 | James C Mcculloch | Specialist/Technologist | 709 Downtowner Loop W, Mobile, AL 36609-5503 | 2017-05-31 |
| 1649710237 | Robert L Fleming IIi Dpt LLC | Physical Therapist | 709 Downtowner Loop W, Suite B, Mobile, AL 36609-5503 | 2017-03-01 |
| 1689903247 | Robert Fleming IIi | Specialist | 709 Downtowner Loop W, Mobile, AL 36609-5503 | 2009-12-10 |
| 1104948512 | Maximum Medical Improvement, P.C. | Specialist | 709 Downtowner Loop W, Ste. B, Mobile, AL 36609-5503 | 2007-04-04 |
| 1356448997 | Robert L. Fleming Jr. P.t., Inc. | Specialist | 709 Downtowner Loop W, Mobile, AL 36609-5503 | 2006-09-17 |
| 1144268301 | Katie Keaton Fletcher | Specialist | 709 Downtowner Loop W, Mobile, AL 36609-5503 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698309 | Bhg Lxxii, LLC | Clinic/Center | 4373 Dowtowner Loop South, Suite A, Mobile, AL 36609 | 2020-10-26 |
| 1760036008 | Jesse David Schultz | Chiropractor | 3501 Montlimar Plaza Drive, Mobile, AL 36609 | 2019-07-25 |
| 1982267241 | Raqueal L. Williams | Registered Nurse | 406 Larose Dr., Mobile, AL 36609 | 2019-04-22 |
| 1588131924 | Angela Roney | Counselor | 705 Oak Circle Dr. East, Mobile, AL 36609 | 2018-10-24 |
| 1134617996 | Harley Michelle Oliver | Physician Assistant | 820 S. University Blvd Bldg 1, Suite 1b, Mobile, AL 36609 | 2018-04-27 |
| 1912420126 | Rural Urgent Care LLC | Clinic/Center | 6280 Grelot Road, Mobile, AL 36609 | 2017-07-19 |
| 1598128407 | Trisha Mcmillon | Counselor | 3929 Airport Blvd Ste 1-214, Mobile, AL 36609 | 2016-03-30 |
| 1437523347 | Sonya White D.d.s. PC | Dentist | 6309 Piccadilly Square Dr., Mobile, AL 36609 | 2015-11-17 |
| 1386913374 | Janis Marie Fausser | Pharmacist | 5705 Cottagehill Rd, Mobile, AL 36609 | 2011-12-20 |
| 1245524263 | Emily Chisholm | Physical Therapist | 1515 University Blvd. S., Mobile, AL 36609 | 2011-06-07 |
| Find all providers in zip 36609 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083021737 | Jhm Medical Services LLC | Specialist | 6801 Airport Blvd Wcc/hbo, Mobile, AL 36608-3709 | 2014-07-15 |
| 1598040461 | Robert S Harlin | Specialist | 75 Clarise Circle, Mobile, AL 36608 | 2011-10-11 |
| 1851522841 | Dr, Timothy Peter Ahmadi M.d. | Specialist | 71 Midtown Park W, Mobile, AL 36606-4151 | 2009-08-07 |
| 1134387913 | Ellen Kay Taylor | Specialist | 1603 Monterey Pl, Mobile, AL 36604-1229 | 2008-05-28 |
| 1548455264 | Angela Karen Mcvay | Specialist | 316b S Sage Ave, Mobile, AL 36606-3616 | 2007-09-06 |
| 1649392051 | Azalea City Physical Therapy | Specialist | 316c S Sage Ave, Mobile, AL 36606-3616 | 2007-04-05 |
| 1306990890 | Michael Biven Lyons | Specialist | 3664 College Ln S, Mobile, AL 36608-1240 | 2007-01-22 |
| 1487702999 | Carl Maltese | Specialist | 1901 Springhill Ave, Mobile, AL 36607 | 2007-01-08 |
| 1396893814 | William R Higgs | Specialist | 3715 Dauphin St 600, Mobile, AL 36608-1774 | 2007-01-08 |
| 1811058613 | William Stephen Martin | Specialist | 6001 Grelot Rd # A, Mobile, AL 36609-3609 | 2006-12-13 |
| Find all providers in MOBILE | ||||
Please comment or provide details below to improve the information on MR. CLINTON BARRETT WALLIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.