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Kelly Ann Clark
Family Medicine Physician in Bethany, Missouri
NPI 1164062972

Kelly Ann Clark is a Family Medicine Physician based in Bethany, MO. Kelly Ann Clark practices in Bethany, MO. The NPI Number for Kelly Ann Clark is 1164062972 and holds a License No. 2020000768 (Missouri).

The current practice location address for Kelly Ann Clark is 3202 Miller St, Bethany, MO and can be reached out via phone at 660-425-3154 and via fax at 660-425-6663.

Location: 3202 Miller St, Bethany, MO, 64424-2713
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164062972
Provider Name
Kelly Ann Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
3202 Miller St, Bethany, MO, 64424-2713
Phone Number
660-425-3154
Fax Number
660-425-6663
Provider Enumeration Date
01/09/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3202 Miller St
City
Bethany
State
Missouri
Zip
64424-2713
Phone Number
660-425-3154
Fax Number
660-425-6663
person
Provider Business Mailing Address Details
Address
3202 Miller St
City
Bethany
State
Missouri
Zip
64424-2713
Phone Number
660-425-3154
Fax Number
660-425-6663
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
2020000768 (Missouri)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
2020000768 (Missouri)
Definition
Definition to come...
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