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DR. RICHARD ALAN CLARK MD

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1700863701

Individual Registrant:
DR. RICHARD ALAN CLARK MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
7219 N LITCHFIELD RD  LUKE AFB HOSPITAL, AZ 85309-1525 US
Tel: 623-856-3763  Fax: --

Contact information for business:
7219 N LITCHFIELD RD  LUKE AFB HOSPITAL, AZ 85309-1525 US
Tel: 623-856-3763  Fax: --

Registration Information:
NPI: 1700863701
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
AZ29948

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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