Provider Demographics
NPI:1083984074
Name:PRINGLE, LAUREN CLOUGH (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:CLOUGH
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:CLOUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:ONE HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-2663
Practice Address - Fax:573-884-4608
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD609138832085R0202X
CAA1530772085R0202X
MO20200281922085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0411056OtherL&I-SWEDISH RADIA EDMONDS
WA0411055OtherL&I-RADIA KING COUNTY
WA2137224Medicaid
WA0411054OtherL&I-RADIA REST OF WA
WA0411057OtherL&I-EVERGREEN RADIA
WA0411060OtherL&I-SEATTLE RADIOLOGY
WA0411058OtherL&I-SOUTH SOUND RADIOLOGY