Clarkston, Kendell C.

Clarkston, Kendell C. is an individual health care provider with primary practice located at 1100 N Kentucky Ave , West Plains MO 65775-2029. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Clarkston, Kendell C. can be contacted via phone (417) 257-5800.

Contact Information

Primary practice address
1100 N Kentucky Ave West Plains MO 65775-2029
Phone: (417) 257-5800
Fax: (417) 257-5999
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 110746 Missouri

Profile Details

NPI number 1922116284
LBN Legal business name Clarkston, Kendell C.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2006
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922116284 NPPES
Missouri MEDICAID 208922419
Missouri MEDICAID 208633001
Missouri Other 128195
Missouri MEDICAID 1922116284

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