Individual
DR. CLARK CHARLES SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
180 FORT WASHINGTON AVE, SUITE 199, NEW YORK, NY 10032-3722
(212) 305-3535
(212) 342-1470
Mailing address
180 FORT WASHINGTON AVE, SUITE 199, NEW YORK, NY 10032-3722
(212) 305-3535
(212) 342-1470
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
260227
NY
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
260227
NY
Other
Enumeration date
12/28/2007
Last updated
07/24/2014
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