Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 28674 | MO |
Y | 111NI0900X | Internist | 28674 | MO |
N | 207RC0000X | Internist - Cardiovascular Disease | 28674 | MO |
N | 207U00000X | Nuclear Medicine Specialist | 28674 | MO |
NPI | 1033187877 |
---|---|
Provider Name | James C Clouse |
First Address | Clinton, MO 64735 |
Second Address | Clinton, MO 64735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 02/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C50888 | (02) | MO |