Clark, Clarence E.

Clark, Clarence E. is an individual health care provider with primary practice located at 1955 W Frye Rd , Chandler AZ 85224-6282. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Clark, Clarence E. can be contacted via phone (480) 728-3000.

Contact Information

Primary practice address
1955 W Frye Rd Chandler AZ 85224-6282
Phone: (480) 728-3000
Fax: (480) 728-4747
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 068132 Georgia
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X N2443 Texas
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 61606 Arizona

Profile Details

NPI number 1952582397
LBN Legal business name Clark, Clarence E.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2007
Last updated Mar 31st, 2021 - about 5 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 1952582397 NPPES
Georgia MEDICAID 003126879C
Georgia MEDICAID 003126879A

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