Healthcare Provider Details

I. General information

NPI: 1598721292
Provider Name (Legal Business Name): LORI A CLAYPOOL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2006
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E SIGLER AVE STE A
MEMPHIS MO
63555-1726
US

IV. Provider business mailing address

855 ILLINI DR STE 408
SILVIS IL
61282-2904
US

V. Phone/Fax

Practice location:
  • Phone: 660-465-2828
  • Fax:
Mailing address:
  • Phone: 309-281-2140
  • Fax: 309-281-2149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1377
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: