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Individual

DR. ZACHARY KYLE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
150 S INGLESIDE ST STE 6, FAIRHOPE, AL 36532-1804
(251) 990-1740
Mailing address
150 S INGLESIDE ST STE 6, FAIRHOPE, AL 36532-1804

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43746
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
315102
AL
Enumeration date
03/27/2020
Last updated
03/07/2024
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