Clark, Roderick V.

Clark, Roderick V. is an sole proprietor health care provider with primary practice located at 2804 Ambassador Caffery Pkwy , Lafayette LA 70506-5906. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Clark, Roderick V. can be contacted via phone (337) 981-5156.

Contact Information

Primary practice address
2804 Ambassador Caffery Pkwy Lafayette LA 70506-5906
Phone: (337) 981-5156
Fax: (337) 981-0673
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 019518 Louisiana

Profile Details

NPI number 1225066939
LBN Legal business name Clark, Roderick V.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 29th, 2006
Last updated Sep 11th, 2007 - about 19 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 1225066939 NPPES
Louisiana MEDICAID 1379875

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