Clark, Mark Wayne

Clark, Mark Wayne is an sole proprietor health care provider with primary practice located at 134 Block St , Marion AR 72364-1956. He recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as his primary health care specialty. Clark, Mark Wayne can be contacted via phone (870) 739-1111.

Contact Information

Primary practice address
134 Block St Marion AR 72364-1956
Fax: (870) 739-1116
Website:

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X AR20895 Arkansas

Profile Details

NPI number 1659856185
LBN Legal business name Clark, Mark Wayne
Credentials DBA MARION FAMILY
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 1st, 2018
Last updated Feb 23rd, 2019 - about 7 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 1659856185 NPPES
Other 0426355 NCPDP

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