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Organization
CLARK MEDICAL, PLLC
Active
Organization
CLARK MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CLARK FNP (OWNER)
(405) 693-5612
Entity
Organization
Contact information
Practice address
2601 N 3RD ST STE 106, PHOENIX, AZ 85004-1144
(405) 693-5612
Mailing address
2601 N 3RD ST STE 106, PHOENIX, AZ 85004-1144
(405) 693-5612
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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