MEDICARE: DR. DELOS J CLOW DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	2004035412	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417949785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DELOS J CLOW DO

Provider Business Mailing Address
First Line	:	2791 N WASHINGTON ST
Second Line	:	HEDRICK OB/GYN ASSOCIATES
City	:	CHILLICOTHEE
State	:	MO
Zip	:	64601-2902
Country	:	US
Telephone Number	:	660-646-2682
Fax Number	:	660-214-8647

Provider Business Practice Location Address
First Line	:	2791 N WASHINGTON ST
Second Line	:	HEDRICK OB/GYN ASSOCIATES
City	:	CHILLICOTHEE
State	:	MO
Zip	:	64601-2902
Country	:	US
Telephone Number	:	660-646-2682
Fax Number	:	660-214-8647

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	03/06/2014

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