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DR. RAYMOND JOSEPH CLYDESDALE D.O. NPI 1699764340


NPI Information

NPI: 1699764340
Provider Name: DR. RAYMOND JOSEPH CLYDESDALE, D.O.
Classification: Preventive Medicine - 2083A0100X
Entity Type: Individual

Specialization: Aerospace Medicine

PECOS Registration: Yes

Address:
375 MEDICAL GROUP
310 W. LOSEY STREET
SCOTT AFB, IL
ZIP 62225
Phone: (618) 256-9355
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DR. Raymond Joseph Clydesdale, D.O. is an aerospace medicine preventive medicine in Scott Afb, IL. The provider is aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures. DR. Raymond Joseph Clydesdale, D.O. NPI is 1699764340. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

375 MEDICAL GROUP
310 W. LOSEY STREET
SCOTT AFB, IL
ZIP 62225
Phone: (618) 256-9355

The NPI 1699764340 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/17/2005 and was last updated on 1/26/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12083X0100XPreventive MedicineOccupational MedicineOS12364PENNSYLVANIANo
22083A0100XPreventive MedicineAerospace MedicineOS12364PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.