Clark, Natasha

Clark, Natasha is an individual health care provider with primary practice located at 24 Joliet St , Dyer IN 46311-1705. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Clark, Natasha can be contacted via phone (317) 322-5747.

Contact Information

Primary practice address
24 Joliet St Dyer IN 46311-1705
Fax: (219) 864-2282
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01079918A Indiana

Profile Details

NPI number 1356752398
LBN Legal business name Clark, Natasha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2014
Last updated Apr 17th, 2023 - about 2 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 1356752398 NPPES
Indiana MEDICAID 300017254

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