Clark, James T

Clark, James T is an individual health care provider with primary practice located at 2302 College Ave , Conway AR 72034-6297. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Clark, James T can be contacted via phone (501) 513-5793.

Contact Information

Primary practice address
2302 College Ave Conway AR 72034-6297
Phone: (501) 513-5793
Fax: (501) 513-5417
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X C6391 Arkansas

Profile Details

NPI number 1548257017
LBN Legal business name Clark, James T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Nov 1st, 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 1548257017 NPPES
Arkansas MEDICAID 102222002
Arkansas MEDICAID 103080001

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