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Individual
KYRA P CLARK
Active
Individual
KYRA P CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
68133
GA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
C1-0007849
DE
207RS0012X
Sleep Medicine (Internal Medicine) Physician
P0967
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125645B
—
GA
05
—
003125645F
—
GA
Enumeration date
03/20/2006
Last updated
10/08/2020
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