Individual
CARRIE CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, ATTN PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
04-31510
KS
207LP3000X
Pediatric Anesthesiology Physician
Primary
2005031609
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207513904
—
MO
Enumeration date
05/04/2006
Last updated
12/11/2025
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