Individual
MICHAEL CLIPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., FAAP
Contact information
Practice address
7245 RAIDER RD, BONNE TERRE, MO 63628-3767
(573) 358-1400
Mailing address
75 REMITT DRIVE, LOCKBOX 1900, CHICAGO, IL 60675-1900
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0000031495
TN
207P00000X
Emergency Medicine Physician
Primary
2000173366
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730106287
—
MO
05
—
204725212
—
MO
05
—
204725246
—
MO
Enumeration date
07/17/2006
Last updated
11/12/2009
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