Clark, David R.

Clark, David R. is an individual health care provider with primary practice located at 1942 Braeburn Cir , Salem VA 24153-7388. 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, David R. can be contacted via phone (540) 444-1240.

Contact Information

Primary practice address
1942 Braeburn Cir Salem VA 24153-7388
Phone: (540) 444-1240
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110-004821 Virginia

Profile Details

NPI number 1194113464
LBN Legal business name Clark, David R.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2015
Last updated Jan 31st, 2022 - about 4 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 1194113464 NPPES
Virginia MEDICAID 1194113464

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