Gary Wayne Clark D.O.

NPI 1013987759 - Family Medicine - 207Q00000X

NPI Details
NPI 1013987759
Gender Male
Enumeration Date 01/25/2006
Last Updated 04/24/2015
Entity Type Individual
Active Over 10 years ago
Practice Location
CARROLLTON OH, 44615-1009, US
Phone (330) 627-7641
Fax (330) 627-5796
Business Location
82 5TH ST NE
CARROLLTON OH, 44615-1214, US
Phone (330) 627-3494
Fax (330) 627-3494
Taxonomy Code 207Q00000X
License State Tennessee
License Number DO785
Remove 1013987759 NPI Number

According to our database, Dr. Gary Wayne Clark D.O. NPI is 1013987759, taxonomy code is 207Q00000X and license number is DO785, license state is located at Tennessee. Gary Wayne Clark D.O. physically located at 125 Canton Rd Nw, Carrollton OH, 44615-1009. NPI Number Gary Wayne Clark D.O. has the Individual type.

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1013987759 NPI number is provided on an as is basis without warranty of any kind. 1013987759 is maintained by the National Plan & Provider Enumeration System. The contents of Gary Wayne Clark D.O. are for informational purposes only.