# ROBERT CLARK MD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTEGRIS AMBULATORY CARE CORP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710179684
- **Legal business name:** INTEGRIS AMBULATORY CARE CORP
- **Authorized official:** BART H DAWSON (VICE PRESIDENT)
- **Authorized official phone:** (405) 951-2987

## Contact information

- **Practice address:** 11401 S. WESTERN, OKLAHOMA CITY, OK 73170
- **Practice address phone:** (405) 735-3041
- **Practice address fax:** (405) 735-3146
- **Mailing address:** PO BOX 960313, OKLAHOMA CITY, OK 73196-0001
- **Mailing address phone:** (405) 951-2298
- **Mailing address fax:** (405) 951-2996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/15/2007
- **Last updated:** 11/13/2007