Clark, Randy Gene

Clark, Randy Gene is an sole proprietor health care provider with primary practice located at 1639 Bruce Smith Pkwy , West Plains MO 65775-7691. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Clark, Randy Gene can be contacted via phone (417) 308-0671.

Contact Information

Primary practice address
1639 Bruce Smith Pkwy West Plains MO 65775-7691
Phone: (417) 308-0671
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 202404464 Missouri
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1063939817
LBN Legal business name Clark, Randy Gene
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 23rd, 2017
Last updated Apr 11th, 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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