Clark, Kathryn M
Clark, Kathryn M is an sole proprietor health care provider with primary practice located at 2101 Jacob St. Suite 201 Valley Prof. Center South, Wheeling WV 26003-6390. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Clark, Kathryn M can be contacted via phone (304) 242-9245.Contact Information
Primary practice address
2101 Jacob St. Suite 201 Valley Prof. Center South
Wheeling WV 26003-6390
Phone: (304) 242-9245
Fax: (304) 242-6870
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 831-OD | West Virginia |
Profile Details
| NPI number | 1750449252 |
|---|---|
| LBN Legal business name | Clark, Kathryn M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 5th, 2006 |
| Last updated | May 4th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750449252 | NPPES |
| West Virginia | Other | DG8768 | RAILROAD MEDICARE WV GROUP PIN |
| West Virginia | Other | DG5587 | RAILROAD MEDICARE WV GROUP PIN |
| West Virginia | MEDICAID | 0149721000 | RAILROAD MEDICARE WV GROUP PIN |
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