Clark, Russell Patrick

Clark, Russell Patrick is an individual health care provider with primary practice located at 6900 N Pecos Rd , North Las Vegas NV 89086-4400. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Clark, Russell Patrick can be contacted via phone (702) 791-9000.

Contact Information

Primary practice address
6900 N Pecos Rd North Las Vegas NV 89086-4400
Phone: (702) 791-9000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 10404 Nevada

Profile Details

NPI number 1790787497
LBN Legal business name Clark, Russell Patrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Jun 19th, 2024 - 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 1790787497 NPPES
Nevada MEDICAID 100504837

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