Clark, Donald Lester

Clark, Donald Lester is an individual health care provider with primary practice located at 725 University Blvd , Dayton OH 45435-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Clark, Donald Lester can be contacted via phone (937) 245-7200.

Contact Information

Primary practice address
725 University Blvd Dayton OH 45435-0001
Phone: (937) 245-7200
Fax: (937) 245-7922
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-114287 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35-120123 Ohio

Profile Details

NPI number 1154313369
LBN Legal business name Clark, Donald Lester
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Apr 1st, 2013 - about 13 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 1154313369 NPPES
Illinois MEDICAID 036114287
Illinois MEDICAID 0073290

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