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Organization
LOWELL F. CLARK MD PA
Active
Organization
LOWELL F. CLARK MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH E FOLK ED.D. (PRESIDENT)
(352) 787-1600
Entity
Organization
Contact information
Practice address
212 S FLORIDA ST, BUSHNELL, FL 33513-6703
(352) 787-1600
(352) 793-3282
Mailing address
212 S FLORIDA ST, BUSHNELL, FL 33513-6703
(352) 787-1600
(352) 793-3282
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME45090
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33972
BCBS OF FLORIDA GROUP ID
FL
Enumeration date
07/24/2007
Last updated
12/21/2007
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