# CLARK CLINIC INC

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

## Provider details

- **NPI number:** 1639693492
- **Authorized official:** DR. LOWELL F CLARK MD (PRESIDENT)
- **Authorized official phone:** (352) 793-2441

## Contact information

- **Practice address:** 910 W MYERS BLVD, MASCOTTE, FL 34753-9748
- **Practice address phone:** (352) 787-1600
- **Practice address fax:** (352) 793-3282
- **Mailing address:** 212 S FLORIDA ST, BUSHNELL, FL 33513-6703
- **Mailing address phone:** (352) 793-2441
- **Mailing address fax:** (866) 407-0034

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/02/2017
- **Last updated:** 04/09/2018