Melvin Jerome Clark M.D.

NPI 1093704751 - Ophthalmology - 207W00000X

NPI Details
NPI 1093704751
Gender Male
Enumeration Date 10/17/2005
Last Updated 08/13/2012
Entity Type Individual
Active Over 11 years ago
Practice Location
4212 N 16TH ST
PHOENIX AZ, 85016-5319, US
Phone (602) 263-1200
Fax (602) 200-5383
Business Location
PO BOX 31001-0698
PASADENA CA, 91110-0698, US
Phone (602) 263-1200
Taxonomy Code 207W00000X
License State Minnesota
License Number 45197
Remove 1093704751 NPI Number

According to our database, Dr. Melvin Jerome Clark M.D. NPI is 1093704751, taxonomy code is 207W00000X and license number is 45197, license state is located at Minnesota. Melvin Jerome Clark M.D. physically located at 4212 N 16th St, Phoenix AZ, 85016-5319. NPI Number Melvin Jerome Clark M.D. has the Individual type.

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1093704751 NPI number is provided on an as is basis without warranty of any kind. 1093704751 is maintained by the National Plan & Provider Enumeration System. The contents of Melvin Jerome Clark M.D. are for informational purposes only.