Individual
CARY L CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111-3220
(816) 932-0340
(816) 932-3148
Mailing address
901 E 104TH ST # MS 400S, KANSAS CITY, MO 64131-4517
(816) 502-7000
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
37624
CO
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
036160603
IL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
2023029930
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45483043
—
CO
01
—
P00094089
MEDICARE RAILROAD
—
Enumeration date
06/14/2006
Last updated
01/23/2025
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