Gunderson, Clark A

Gunderson, Clark A is an sole proprietor health care provider with primary practice located at 1717 Oak Park Blvd Fl 3 , Lake Charles LA 70601-8990. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Ambulatory Health Care Facilities / Clinic/Center. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Gunderson, Clark A can be contacted via phone (337) 439-0385.

Contact Information

Primary practice address
1717 Oak Park Blvd Fl 3 Lake Charles LA 70601-8990
Phone: (337) 439-0385
Fax: (337) 433-5448
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 12489 Louisiana
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 012489 Louisiana

Profile Details

NPI number 1083831887
LBN Legal business name Gunderson, Clark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 20th, 2007
Last updated Feb 20th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1083831887 NPPES
Louisiana Other 1861766321 NPPES
Louisiana MEDICAID 1141305 NPPES
Louisiana MEDICAID 3073307 NPPES

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