Clark, Roger Galen
Clark, Roger Galen is an sole proprietor health care provider with primary practice located at Blanchfield Army Community Hospital 650 Joel Dr, Fort Campbell KY 42223-5349. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Prescribing (Medical). Behavioral Health & Social Service Providers / Prescribing (Medical) is his primary health care specialty. Clark, Roger Galen can be contacted via phone (270) 956-0129.Contact Information
Primary practice address
Blanchfield Army Community Hospital 650 Joel Dr
Fort Campbell KY 42223-5349
Phone: (270) 956-0129
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1187 | Kentucky |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2800 | Tennessee |
| Behavioral Health & Social Service Providers / Prescribing (Medical) | 103TP0016X | 322138 | Louisiana |
Profile Details
| NPI number | 1669501136 |
|---|---|
| LBN Legal business name | Clark, Roger Galen |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 2nd, 2007 |
| Last updated | May 31st, 2023 - about 3 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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