Clark, Edward

Clark, Edward is an individual health care provider with primary practice located at 595 W Lake Mead Pkwy , Henderson NV 89015-7015. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Clark, Edward can be contacted via phone (702) 565-1007.

Contact Information

Primary practice address
595 W Lake Mead Pkwy Henderson NV 89015-7015
Phone: (702) 565-1007
Fax: (702) 565-0836
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 11309 Nevada

Profile Details

NPI number 1356318174
LBN Legal business name Clark, Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Oct 17th, 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 1356318174 NPPES
Nevada MEDICAID 1005063739
Nevada MEDICAID 100506374
Nevada MEDICAID 1356318174
Nevada Other 11309
Nevada Other 11309

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