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STANLEY D CLARKE M.D.
Radiation Oncology >> Radiology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1104829688
Individual Registrant: STANLEY D CLARKE M.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1110 S JACKSON HWY SHEFFIELD, AL 35660-5747 US
Tel: 256-383-5211 Fax: 256-381-1517
Tel: 256-383-5211 Fax: 256-381-1517
Contact information for business:
15055 COLLECTION CENTER DR CHICAGO, IL 60693-0001 US
Tel: 256-383-3325 Fax: 480-212-8451
Tel: 256-383-3325 Fax: 480-212-8451
Registration Information:
NPI: 1104829688
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2085R0001X | Allopathic & Osteopathic Physicians Radiology Radiation Oncology | AL | 00019049 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| BCBS AL | 515-45256 | AL | 01 |
| 009973900 | AL | 05 | |
| 103413 | AL | 05 | |
| AL BCBS | 051504900 | AL | 01 |
| AL BCBS | 051504899 | AL | 01 |
| 529909740 | AL | 05 | |
| 051550973 | AL | 05 | |
| 103086 | AL | 05 | |
| BCBS AL | 515-45255 | AL | 01 |
