Individual
DR. CLINTON D HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3901 RAINBOW BLVD, MS 3010, KANSAS CITY, KS 66160-0001
(913) 588-6701
(913) 588-6708
Mailing address
PO BOX 411851, KANSAS UNIVERSITY PHYSICIANS INC, KANSAS CITY, MO 64141-1851
(913) 588-6701
(913) 588-6708
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
9405983
KS
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
04-33336
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204511208
—
MO
Enumeration date
12/21/2006
Last updated
05/20/2020
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