# W BRUCE CLARK MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396959110
- **Authorized official:** DENISE MCNAMARA (MEDICAL BILLER)
- **Authorized official phone:** (518) 783-1472

## Contact information

- **Practice address:** 585 NEW LOUDON RD, LATHAM, NY 12110-5701
- **Practice address phone:** (518) 783-1472
- **Practice address fax:** (518) 783-1605
- **Mailing address:** 585 NEW LOUDON RD, LATHAM, NY 12110-5701
- **Mailing address phone:** (518) 783-1472
- **Mailing address fax:** (518) 783-1605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NY | Yes |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 02/26/2008