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Individual

WENDELL KEVAN CLARKSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4320 WORNALL RD, SUITE 240, KANSAS CITY, MO 64111-5941
(816) 932-7940
Mailing address
901 E 104TH ST, MAILSTOP 400, KANSAS CITY, MO 64131
(816) 599-9499
(816) 932-9670

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
0429011
KS
207RG0100X
Gastroenterology Physician
Primary
R1732
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202516639
MO
Enumeration date
06/20/2006
Last updated
11/16/2017
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