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Individual
CLARK TIMOTHY JOHNSON
Active
Individual
CLARK TIMOTHY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
D76370
MD
207V00000X
Obstetrics & Gynecology Physician
MD490154
PA
207VM0101X
Maternal & Fetal Medicine Physician
Primary
MD490154
PA
Other
Enumeration date
05/06/2009
Last updated
07/07/2025
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