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Individual

DR. LLOYD J CLEAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1316 COUNTRY CLUB DR, KIRKSVILLE, MO 63501-5362
(660) 627-7546
(660) 956-7097
Mailing address
1316 COUNTRY CLUB DR, KIRKSVILLE, MO 63501-5362
(660) 627-7546
(660) 956-7097

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
R8895
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000014853
MEDICARE GROUP #
01
070004124
RAILROAD MEDICARE
MO
05
242210912
MO
01
501218200
MEDICAID GROUP#
MO
01
DG4290
RAILROAD MEDICARE GROUP#
MO
Enumeration date
05/27/2005
Last updated
07/08/2013
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