Provider Demographics
NPI:1801891718
Name:CLIFTON, COURTNEY C (MD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:C
Last Name:CLIFTON
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 1:634 SW MULVANE ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1678
Mailing Address - Country:US
Mailing Address - Phone:785-295-8149
Mailing Address - Fax:785-295-5529
Practice Address - Street 1:634 SW MULVANE ST
Practice Address - Street 2:SUITE 105
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1678
Practice Address - Country:US
Practice Address - Phone:785-295-8149
Practice Address - Fax:785-295-5529
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004006661207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209420108Medicaid
MO209420108Medicaid
MOI14333Medicare UPIN