Individual
DR. KIM P LARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2402 W PIERCE ST, SUITE 4-A, CARLSBAD, NM 88220-3537
(575) 234-9964
(575) 234-9962
Mailing address
2402 W PIERCE ST, SUITE 4-A, CARLSBAD, NM 88220-3537
(575) 234-9964
(575) 234-9962
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A110698
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T9592
—
NM
Enumeration date
10/31/2005
Last updated
01/02/2014
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