Clark, Teralynn S

Clark, Teralynn S is an individual health care provider with primary practice located at 1201 Mickelson Dr Ste 2 , Watertown SD 57201-7253. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Clark, Teralynn S can be contacted via phone (605) 882-0432.

Contact Information

Primary practice address
1201 Mickelson Dr Ste 2 Watertown SD 57201-7253
Phone: (605) 882-0432
Fax: (605) 882-0978
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 4316 South Dakota

Profile Details

NPI number 1699789263
LBN Legal business name Clark, Teralynn S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Feb 22nd, 2013 - about 13 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 1699789263 NPPES
South Dakota Other 0007400 BCBS
South Dakota MEDICAID 235822100 BCBS
South Dakota MEDICAID 5707122 BCBS
South Dakota Other 59F05CL BCBS

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