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Individual

TIMOTHY M CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4820 RIVERBEND RD STE 100, BOULDER, CO 80301-2618
(303) 415-5399
(303) 297-5808
Mailing address
5450 WESTERN AVE, BOULDER, CO 80301-2709
(303) 415-5399
(303) 297-5808

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
38716
CO
207RP1001X
Pulmonary Disease Physician
Primary
38716
CO

Other

Enumeration date
05/23/2006
Last updated
05/10/2019
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