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STANLEY D CLARKE M.D.

Radiation Oncology >> Radiology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1104829688

Individual Registrant:
 STANLEY D CLARKE M.D.
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

Contact information for business:
15055 COLLECTION CENTER DR  CHICAGO, IL 60693-0001 US
Tel: 256-383-3325  Fax: 480-212-8451

Registration Information:
NPI: 1104829688
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2085R0001XAllopathic & Osteopathic Physicians
Radiology
Radiation Oncology
AL00019049

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BCBS AL515-45256AL01
009973900AL05
103413AL05
AL BCBS051504900AL01
AL BCBS051504899AL01
529909740AL05
051550973AL05
103086AL05
BCBS AL515-45255AL01




HEALTH CARE JOBS AL - Page 1



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