Provider Demographics
NPI:1700850443
Name:CLEMENS, BETSY F (MD)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:F
Last Name:CLEMENS
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:450 N NEW BALLAS RD
Mailing Address - Street 2:SUITE 266N
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6835
Mailing Address - Country:US
Mailing Address - Phone:314-991-9888
Mailing Address - Fax:314-991-9886
Practice Address - Street 1:450 N NEW BALLAS RD
Practice Address - Street 2:SUITE 266N
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6835
Practice Address - Country:US
Practice Address - Phone:314-991-9888
Practice Address - Fax:314-991-9886
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2020-12-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO106302207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208226903Medicaid
MO208226903Medicaid