Clark, Shane B

Clark, Shane B is an individual health care provider with primary practice located at 2310 Village Square Pkwy Ste 106C , Fleming Island FL 32003-6409. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Medical Oncology, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is his primary health care specialty. Clark, Shane B can be contacted via phone (904) 202-7300.

Contact Information

Primary practice address
2310 Village Square Pkwy Ste 106C Fleming Island FL 32003-6409
Phone: (904) 202-7300
Fax: (904) 202-2754
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207RH0000X OS21375 Florida
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X OS21375 Florida
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X OS21375 Florida

Profile Details

NPI number 1902391477
LBN Legal business name Clark, Shane B
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2018
Last updated Apr 30th, 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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