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Contact Information

ANTONIO O CLINKSCALES
103 SURREY DR
RUTHER GLEN, VA22546-1035
 Phone: 804-994-7998
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pastoral

101YP1600X
Indicates primary specialty

NPI Profile & details for ANTONIO O CLINKSCALES · (Male)

NPI # 1184182719
Status Active
Credentials
Entity Individual
Enumeration date 03/02/2019
Last updated 03/02/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • VA Medicaid 81-5150005
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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