Andrew Thomas Clark PA

NPI 1497008254 - Physician Assistant - 363A00000X

NPI Details
NPI 1497008254
Gender Male
Enumeration Date 10/17/2012
Last Updated 08/07/2015
Entity Type Individual
Active Over 4 years ago
Practice Location
12303 DE PAUL DR
BRIDGETON MO, 63044-2512, US
Phone (314) 317-0600
Fax (314) 317-0606
Business Location
SAINT LOUIS MO, 63141-5047, US
Phone (314) 317-0600
Fax (314) 747-4111
Taxonomy Code 363A00000X
License State Missouri
License Number 2013001474
Remove 1497008254 NPI Number

According to our database, Mr. Andrew Thomas Clark PA NPI is 1497008254, taxonomy code is 363A00000X and license number is 2013001474, license state is located at Missouri. Andrew Thomas Clark PA physically located at 12303 De Paul Dr, Bridgeton MO, 63044-2512. NPI Number Andrew Thomas Clark PA has the Individual type.

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1497008254 NPI number is provided on an as is basis without warranty of any kind. 1497008254 is maintained by the National Plan & Provider Enumeration System. The contents of Andrew Thomas Clark PA are for informational purposes only.