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Individual
JAMES W CLARK
Active
Individual
JAMES W CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0110002588
VA
363A00000X
Physician Assistant
C00003565
MD
363A00000X
Physician Assistant
Primary
PA200001310
DC
Other
Enumeration date
10/16/2007
Last updated
05/12/2022
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