Clark, Christopher William

Clark, Christopher William is an individual health care provider with primary practice located at 701 E County Line Rd Ste 101 , Greenwood IN 46143-1070. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Clark, Christopher William can be contacted via phone (317) 885-2860.

Contact Information

Primary practice address
701 E County Line Rd Ste 101 Greenwood IN 46143-1070
Phone: (317) 885-2860
Fax: (317) 885-2869
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10002612A Indiana

Profile Details

NPI number 1477036291
LBN Legal business name Clark, Christopher William
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2018
Last updated Mar 19th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477036291 NPPES
Indiana MEDICAID 300020884

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