Harris, Clinton Lee
Harris, Clinton Lee is an individual health care provider with primary practice located at 1241 W Stadium Blvd , Jefferson City MO 65109-6023. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Harris, Clinton Lee can be contacted via phone (573) 556-1706.Contact Information
Primary practice address
1241 W Stadium Blvd
Jefferson City MO 65109-6023
Phone: (573) 556-1706
Fax: (573) 556-5728
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 35473 | Iowa |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 2014015594 | Missouri |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 35473 | Iowa |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 2014015594 | Missouri |
Profile Details
| NPI number | 1417940321 |
|---|---|
| LBN Legal business name | Harris, Clinton Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2005 |
| Last updated | Aug 16th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417940321 | NPPES |
| Iowa | MEDICAID | 0462077 |
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