Kelly J Clark M.D.

NPI 1063450377 - Psychiatry & Neurology - 2084P0800X

NPI Details
NPI 1063450377
Gender Female
Enumeration Date 06/02/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
3430 NEWBURG RD
LOUISVILLE BEHAVIORAL SUITE 212
LOUISVILLE KY, 40218-2497, US
Phone (502) 333-0160
Fax
Business Location
PO BOX 86
GLENVIEW KY, 40025-0086, US
Phone (502) 333-0160
Fax
Toxanomy
Taxonomy Code 2084P0800X
License State Massachusetts
License Number 81665
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According to our database, Kelly J Clark M.D. NPI is 1063450377, taxonomy code is 2084P0800X and license number is 81665, license state is located at Massachusetts. Kelly J Clark M.D. physically located at 3430 Newburg Rd, Louisville KY, 40218-2497. NPI Number Kelly J Clark M.D. has the Individual type.

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1063450377 NPI number is provided on an as is basis without warranty of any kind. 1063450377 is maintained by the National Plan & Provider Enumeration System. The contents of Kelly J Clark M.D. are for informational purposes only.