Individual
JOHN A CLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5340 COLLEGE BLVD, OVERLAND PARK, KS 66211-1621
(816) 942-0200
(816) 942-0205
Mailing address
PO BOX 412892, KANSAS CITY, MO 64141-2892
(816) 942-0200
(816) 942-0205
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
04-29963
KS
207T00000X
Neurological Surgery Physician
Primary
106552
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100458340A
KS MEDICAID
KS
05
—
205104904
—
MO
01
—
P00353063
MEDICARE RR
MO
01
—
W73A634
MEDICARE
MO
Enumeration date
06/27/2006
Last updated
02/01/2022
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