Clark, Denise Maureen

Clark, Denise Maureen is an sole proprietor health care provider with primary practice located at 24690 Bench Ln , Oak Creek CO 80467-8545. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Clark, Denise Maureen can be contacted via phone (970) 879-7241.

Contact Information

Primary practice address
24690 Bench Ln Oak Creek CO 80467-8545
Phone: (970) 879-7241
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 30559 Iowa

Profile Details

NPI number 1235122052
LBN Legal business name Clark, Denise Maureen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 26th, 2005
Last updated Sep 16th, 2009 - about 17 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 1235122052 NPPES
Iowa MEDICAID 2123158
Iowa Other 24232

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