Provider Demographics
NPI:1992088900
Name:CLAUSEN, CARL CHRIS (RPH)
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:CHRIS
Last Name:CLAUSEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 EVENING LN
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-4117
Mailing Address - Country:US
Mailing Address - Phone:417-582-0445
Mailing Address - Fax:417-485-0793
Practice Address - Street 1:1675 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-5152
Practice Address - Country:US
Practice Address - Phone:417-485-0762
Practice Address - Fax:417-485-0793
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005036832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist