# BRADLEY A CLARK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1447510722
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 02005391A | IN | — |
| 207RC0000X | Cardiovascular Disease Physician | 02005391A | IN | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | 02005391A | IN | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | — |

## Other

- **Enumeration date:** 05/21/2012
- **Last updated:** 06/14/2022