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Contact Information

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

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for CLINT VANLANDINGHAM

NPI Number 1144283524
LBN Legal business name CLINT VANLANDINGHAM
Authorized official CLINT VANLANDINGHAM - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/07/2006
Last updated 05/15/2020 - About 6 years ago
Identifiers
MO License # 2004001321
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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