Timothy Michael Clark CRNA

NPI 1912017039 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1912017039
Gender Male
Enumeration Date 08/30/2006
Last Updated 10/10/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
TYLER TX, 75701-2036, US
Phone (903) 531-2668
Business Location
PO BOX 841656
DALLAS TX, 75284-1656, US
Phone (903) 531-4522
Taxonomy Code 367500000X
License State Texas
License Number 074887
Remove 1912017039 NPI Number

According to our database, Timothy Michael Clark CRNA NPI is 1912017039, taxonomy code is 367500000X and license number is 074887, license state is located at Texas. Timothy Michael Clark CRNA physically located at 800 E Dawson St, Tyler TX, 75701-2036. NPI Number Timothy Michael Clark CRNA has the Individual type.

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1912017039 NPI number is provided on an as is basis without warranty of any kind. 1912017039 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy Michael Clark CRNA are for informational purposes only.