Individual
MR. TIMOTHY PAT CLARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6122
(816) 271-6019
Mailing address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6122
(816) 271-6019
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
15-00296
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042G3
PHYSICIAN ASSISTANT
MO
Enumeration date
04/05/2006
Last updated
03/17/2018
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