Provider Demographics
NPI:1780965343
Name:CLARKIN, MEGAN DAWN (DO)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:DAWN
Last Name:CLARKIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MERCY WAY
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4524
Mailing Address - Country:US
Mailing Address - Phone:417-781-2727
Mailing Address - Fax:417-208-3625
Practice Address - Street 1:100 MERCY WAY
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4524
Practice Address - Country:US
Practice Address - Phone:417-781-2727
Practice Address - Fax:417-208-3625
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5066207R00000X
MO2013020393207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1780965343Medicaid
KS2010834640AMedicaid
KS2010834640AMedicaid
MO1780965343Medicaid