Individual
CLINTON MICHAEL CLOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3800 S NATIONAL AVE STE 510, SPRINGFIELD, MO 65807-5284
(417) 875-3160
(417) 875-3410
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220081103
—
MO
Enumeration date
02/26/2020
Last updated
03/24/2020
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