Clark, Dennis Dewayne

Clark, Dennis Dewayne is an individual health care provider with primary practice located at 111 Town Center Dr , Anniston AL 36205-4101. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Clark, Dennis Dewayne can be contacted via phone (256) 237-1624.

Contact Information

Primary practice address
111 Town Center Dr Anniston AL 36205-4101
Phone: (256) 237-1624
Fax: (256) 238-0555
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 23397 Alabama

Profile Details

NPI number 1356313969
LBN Legal business name Clark, Dennis Dewayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Jul 28th, 2011 - about 15 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 1356313969 NPPES
Alabama Other 020048856 UNITED HEALTHCARE
Alabama Other 51097064 UNITED HEALTHCARE
Alabama MEDICAID 000097064 UNITED HEALTHCARE

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