Harris, Clinton Lee

Harris, Clinton Lee is an individual health care provider with primary practice located at 1241 W Stadium Blvd , Jefferson City MO 65109-6023. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Harris, Clinton Lee can be contacted via phone (573) 556-1706.

Contact Information

Primary practice address
1241 W Stadium Blvd Jefferson City MO 65109-6023
Phone: (573) 556-1706
Fax: (573) 556-5728
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 35473 Iowa
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 2014015594 Missouri
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 35473 Iowa
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 2014015594 Missouri

Profile Details

NPI number 1417940321
LBN Legal business name Harris, Clinton Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2005
Last updated Aug 16th, 2023 - about last year

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 1417940321 NPPES
Iowa MEDICAID 0462077

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