# ROY ELLIS CLARK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1285808188
- **Gender:** Man
- **Credential:** M.S., CCC-A

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | 23002042 | IN | Yes |
| 237600000X | Audiologist-Hearing Aid Fitter | 23002042 | IN | — |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 05/15/2025