Clough, Lisa A

Clough, Lisa A is an individual health care provider with primary practice located at 3901 Rainbow Boulevard 6067 Delp, Mail Stop 1028, Kansas City KS 66160. She recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as her primary health care specialty. Clough, Lisa A can be contacted via phone (913) 588-6035.

Contact Information

Primary practice address
3901 Rainbow Boulevard 6067 Delp, Mail Stop 1028 Kansas City KS 66160
Phone: (913) 588-6035
Fax: (913) 945-6916
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 04-25575 Kansas

Profile Details

NPI number 1780787697
LBN Legal business name Clough, Lisa A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated May 8th, 2014 - about 10 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 1780787697 NPPES
Missouri MEDICAID 207287400
Missouri Other 35034016
Missouri Other 926001
Missouri MEDICAID 200309880A

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