DR. Edward Petersen Clack DO

  • NPI 1659629053
According to our database, the NPI number for DR. Edward Petersen Clack DO is 1659629053 and activated since 11 years ago. DR. Edward Petersen Clack DO is an individual provider who specializes in Family Medicine, and the primary practice location is 68 Darst Rd, Beavercreek, OH 45440. You can also contact DR. Edward Petersen Clack DO via telephone number is (937) 531-0132. Provider NPI information was last updated on 11/25/2020.

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Overview of DR. Edward Petersen Clack DO

  • NPI number: 1598434045
  • Provider type: Individual
  • Gender: Male
  • Active since: 08/16/2012
  • Last updated: 11/25/2020

Primary Scrop of Practice

  • Taxonomy Code: 207Q00000X
  • Specialty: Family Medicine
  • License Number: 34.011463
  • License State: OH

Provider Mailing Address

  • Address: 68 Darst Rd
    Beavercreek, OH 45440
  • Phone: 937-531-0132
  • Fax: 937-531-0134

Provider Practice Location

  • Address: 68 Darst Rd
    Beavercreek, OH 45440
  • Phone: 937-531-0132
  • Fax: 937-531-0134

Scope of Practice

  • Taxonomy Code: 207Q00000X
  • Specialty: Family Medicine
  • License Number: 34.011463
  • License State: OH
  • Switch: Yes

Legacy Identifiers

  • Provider Identifier: 0122811
  • Identifier Type: Medicare Oscar/Certification
  • Identifier State: OH
  • Issuer:

Question & Answers

  • Q: What is the npi number?
  • A: An NPI is a 10-digit numeric identifier. It does not carry information about you, such as the State where you practice, your provider type, or your specialization. Your NPI will not change, even if your name, address, taxonomy, or other information changes.
  • Q: What are health care provider taxonomy codes?
  • A: The Health Care Provider (HCP) Taxonomy Codes Codes define a health care service provider type, classification, and area of specialization.
  • Q: What is the npi number for DR. Edward Petersen Clack DO?
  • A: The npi number for DR. Edward Petersen Clack DO is 1659629053.
  • Q: What are DR. Edward Petersen Clack DO's specialties?
  • A: DR. Edward Petersen Clack DO's specialties are Family Medicine and different specialities.
  • Q: What is the medical license for DR. Edward Petersen Clack DO?
  • A: The medical license number for DR. Edward Petersen Clack DO is 34.011463 and issued in OH in USA.
  • Q: Where is DR. Edward Petersen Clack DO practice location?
  • A: DR. Edward Petersen Clack DO is practicing at 68 Darst Rd, Beavercreek, OH 45440.
  • Q: How to contact DR. Edward Petersen Clack DO?
  • A: You can contact DR. Edward Petersen Clack DO via 937-531-0132.
Medicare Specialty
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Addiction Medicine
Clinical Pharmacology
Family Medicine
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Dental Public Health
Optometrist
Occupational Health
Sports Physician
Mental Health
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Ph.D. Medical Genetics
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Clinical Nurse Specialist
Family Health
Nurse Massage Therapist
Sports Medicine
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