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General NPI Number Information
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NPI Number | 1346358579
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Entity Type | Individual
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Provider Name | LAURIE A. CLARKSTON M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 2303 HIGGINS RD STE F
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City | PLATTE CITY
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State | MO
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Zip | 64079-7101
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Country | US
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Telephone | 913-758-6980
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Fax | 913-775-8681
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Provider Business Mailing Address
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Address Line | 4101 S 4TH ST
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5014
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Country | US
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Telephone | 913-682-2000
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Fax | 913-758-6815
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2000154878
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License Number State | MO
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