Individual
CLAYTON EARL WHETMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1205 N MISSOURI ST, MACON, MO 63552-2095
(660) 385-8700
Mailing address
1205 N MISSOURI ST, MACON, MO 63552-2095
(660) 385-8700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2004030585
MO
207Q00000X
Family Medicine Physician
2004030585
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000012067
MEDICARE NON-RURAL HEALTH
MO
05
—
242072627
—
MO
01
—
263834
MEDICARE RURAL HEALTH
MO
05
—
501720809
—
MO
05
—
591720800
—
MO
Enumeration date
11/24/2006
Last updated
01/24/2020
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