Individual
KEVIN R CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
420 N CENTER ST, HICKORY, NC 28601-5046
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 60359, CHARLOTTE, NC 28260-0359
(843) 237-3378
(843) 237-5073
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200300020
NC
208D00000X
General Practice Physician
200300020
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1293C
BCBS
NC
05
—
891293C
—
NC
01
—
P00251742
RAILROAD MEDICARE
NC
Enumeration date
04/03/2006
Last updated
12/23/2025
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