Provider Demographics
NPI:1063622058
Name:WEITH, CLIFFORD VOYD II (DO)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:VOYD
Last Name:WEITH
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6727 NW MONTICELLO TER
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-5706
Mailing Address - Country:US
Mailing Address - Phone:816-679-7275
Mailing Address - Fax:
Practice Address - Street 1:2800 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3220
Practice Address - Country:US
Practice Address - Phone:816-346-7220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207P00000X
MO2008011546207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00635001OtherRR MEDICARE GROUP CD1534
MO1063622058Medicaid
MO40260015OtherBCBS OF KC MO GROUP 10408016
MO40260015OtherBCBS OF KC MO GROUP 10408016