Individual
DR. ZACHARY EUGENE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35318
AL
208D00000X
General Practice Physician
35318
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35318
STATE MEDICAL LICENSE
AL
Enumeration date
05/19/2014
Last updated
06/01/2023
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