Clark, Randolph A

Clark, Randolph A is an individual health care provider with primary practice located at 2510 W Dunlap Ave Ste 290 , Phoenix AZ 85021-2759. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Clark, Randolph A can be contacted via phone (602) 789-0344.

Contact Information

Primary practice address
2510 W Dunlap Ave Ste 290 Phoenix AZ 85021-2759
Phone: (602) 789-0344
Fax: (602) 789-8389
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 26212 Nevada
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 27792 Arizona

Profile Details

NPI number 1568456036
LBN Legal business name Clark, Randolph A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2005
Last updated Apr 7th, 2025 - about last year

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 1568456036 NPPES
Arizona MEDICAID 648751

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