Jacoby Markie Clemons, ATC
Specialist/Technologist, Athletic Trainer in Fayetteville, AR. Individual provider (NPI-1).
NPI number1225520828
StatusActive
Last updated in NPPESMay 31, 2018
Details
- NPI
- 1225520828
- Entity type
- Individual (NPI-1)
- Name
- Jacoby Markie Clemons
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 31, 2018
- Last updated
- May 31, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
1201 West Leroy Pond DrFayetteville, AR 72701
Phone 585-317-5771
Mailing address
1036 S Dunn Ave # 204aFayetteville, AR 72701-5529
Phone 585-317-5771
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All 59 Athletic Trainer providers in Fayetteville · All 4,767 providers in Fayetteville
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