DR. CLYDE ALLEN (NPI# 1912914268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912914268 |
| Entity Type | Individual |
| Full Name | DR. CLYDE ALLEN |
| Credential | M. D. |
| Practice Address |
227 S 13th Ave Laurel MS 39440-4225 |
| Mailing Address |
Po Box 2427 Laurel MS 39442-2427 |
| Practice Telephone | 6017092145 |
| Mailing Telephone | 6017092145 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2085B0100X |
Radiology Specialization: Body Imaging |
05238 | MS | Allopathic & Osteopathic Physicians |
| X | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
05238 | MS | Allopathic & Osteopathic Physicians |
| X | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
05238 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00014472 | 05 | |
| GROUP MEDICARE NPI | 1942214846 | 01 |
| Street Address |
227 S 13TH AVE |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528096112 | South Central Regional Open Mri, LLC | Physiological Laboratory | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-06-30 |
| 1225219405 | Steven Blaine Quin | Radiology | 227 S 13th Ave, Laurel, MS 39440-4225 | 2007-11-16 |
| 1912913757 | Dana Chard | Radiology | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-08-01 |
| 1366458119 | Ronald Gatewood | Radiology | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-08-01 |
| 1497762744 | Peeler Lacey | Radiology | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-08-01 |
| 1700893047 | Daniel Frederick Vial | Radiology | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285694406 | James William Miller | Radiology | 7317 Shell Bridge Rd., Laurel, DE 19931-0166 | 2006-03-23 |
| 1912913757 | Dana Chard | Radiology | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-08-01 |
| 1366458119 | Ronald Gatewood | Radiology | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-08-01 |
| 1497762744 | Peeler Lacey | Radiology | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-08-01 |
| 1700893047 | Daniel Frederick Vial | Radiology | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790720779 | Jason Kendell Morris | Radiology | 618 Frederick Dr, Cleveland, MS 38732-2006 | 2006-06-16 |
| 1811229057 | Leena Pande | Radiology | 14231 Seaway Rd Ste 5003, Gulfport, MS 39503-4660 | 2010-02-12 |
| 1033318985 | Sunder Jagwani Md Pa | Radiology | 1401 River Rd, Greenwood, MS 38930-4030 | 2007-07-12 |
| 1902000375 | Simpson Community Healthcare, Inc. | Radiology | 1842 Simpson Highway 149, Mendenhall, MS 39114-3438 | 2007-06-12 |
| 1790993749 | South Sunflower County Hospital | Radiology | 121 E Baker St, Indianola, MS 38751-2450 | 2007-05-21 |
| 1326256371 | South Sunflower County Hospital | Radiology | 121 E Baker St, Indianola, MS 38751-2450 | 2007-05-21 |
| 1487770152 | Oktibbeha County Hospital | Radiology | 400 Hospital Rd, Starkville, MS 39759-2163 | 2007-03-22 |
| 1457491383 | Sunder H Jagwani | Radiology | 1401 River Rd, Greenwood, MS 38930-4030 | 2007-02-08 |
| 1528158532 | Phc-cleveland Inc | Radiology | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2006-10-13 |
| 1407941339 | Vicente Co Luciano Jr. | Radiology | 840 N Oak Ave, Ruleville, MS 38771-3227 | 2006-10-04 |
| Find all providers with the same taxonomy | ||||
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| 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.