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Contact Information

CLINT L VANLANDINGHAM, DPM
2600 KANELL BLVD
POPLAR BLUFF, MO63901-3001
 Phone: 573-785-4546
 Fax: 573-785-6959
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Family

363LF0000X 50 Nurse Practitioner
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for CLINT L VANLANDINGHAM · (Male)

NPI # 1508838566
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 02/03/2006
Last updated 01/27/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 2004001321
  • MO License # 2014037662
  • MO Medicaid 309166510
Hospital affiliation(s)
  • MISSOURI SOUTHERN HEALTHCARE - (Acute Care)
    1200 N ONE MILE RD
    DEXTER, MO 63841
  • POPLAR BLUFF REGIONAL MEDICAL CENTER - (Acute Care)
    3100 OAK GROVE ROAD
    POPLAR BLUFF, MO 63901
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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