| Michael Clippard, MD, FAAP | |
|
7245 Raider Rd, Bonne Terre, MO 63628-3767 | |
| (573) 358-1400 | |
| Not Available |
| Full Name | Michael Clippard |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 7245 Raider Rd, Bonne Terre, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730106287 | NPI | - | NPPES |
| 204725212 | Medicaid | MO | |
| 204725246 | Medicaid | MO | |
| 1730106287 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 0000031495 (Tennessee) | Secondary |
| 207P00000X | Emergency Medicine | 2000173366 (Missouri) | Primary |
| Entity Name | Southeastern Emergency Physicians Of Memphis Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437105277 PECOS PAC ID: 5395643209 Enrollment ID: O20060711000434 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Clippard, MD, FAAP 75 Remitt Drive, Lockbox 1900, Chicago, IL 60675-1900 Ph: (866) 916-5259 | Michael Clippard, MD, FAAP 7245 Raider Rd, Bonne Terre, MO 63628-3767 Ph: (573) 358-1400 |
Ralph Leigh, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 7245 Raider Rd, Bonne Terre, MO 63628 Phone: 573-358-1400 | |
Dr. Phillip A. Brewer, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 7245 Raider Rd, Bonne Terre, MO 63628 Phone: 203-376-4684 | |
Gerardo Gutierrez, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 7245 Raider Rd, Bonne Terre, MO 63628 Phone: 573-468-4186 |