Clark, Cullen J

Clark, Cullen J is an individual health care provider with primary practice located at 700 Childrens Dr , Columbus OH 43205-2664. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Clark, Cullen J can be contacted via phone (614) 722-2000.

Contact Information

Primary practice address
700 Childrens Dr Columbus OH 43205-2664
Phone: (614) 722-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 35-138842 Ohio
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 35-138842 Ohio

Profile Details

NPI number 1114314267
LBN Legal business name Clark, Cullen J
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2015
Last updated Feb 1st, 2022 - about 3 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 1114314267 NPPES
Ohio MEDICAID 0393860

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