Provider Demographics
NPI:1114907136
Name:PARSONS, CLYDE W III (MD)
Entity Type:Individual
Prefix:DR
First Name:CLYDE
Middle Name:W
Last Name:PARSONS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4046
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-4046
Mailing Address - Country:US
Mailing Address - Phone:417-882-8437
Mailing Address - Fax:417-882-9587
Practice Address - Street 1:3800 S NATIONAL
Practice Address - Street 2:#700
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807
Practice Address - Country:US
Practice Address - Phone:417-882-8437
Practice Address - Fax:417-882-9587
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7310207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200913432Medicaid
MO200913432Medicaid