Provider Demographics
NPI:1962636944
Name:CLOUSE, KARI R (MD)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:R
Last Name:CLOUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KS
Mailing Address - Zip Code:67010-2361
Mailing Address - Country:US
Mailing Address - Phone:316-775-7500
Mailing Address - Fax:316-775-3685
Practice Address - Street 1:307 W HWY 54 STE 300
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-7849
Practice Address - Country:US
Practice Address - Phone:316-218-0008
Practice Address - Fax:316-218-0003
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-34441207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200632830AMedicaid
KS200969150AMedicaid
KS102644004Medicare UPIN
KS200632830AMedicaid