Individual
DR. CARLOS STANFORD CLARK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 DOCTORS DRIVE, DOTHAN, AL 36301
(334) 794-6612
(334) 794-6614
Mailing address
201 DOCTORS DRIVE, DOTHAN, AL 36301
(334) 794-6612
(334) 794-6614
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.32611
AL
207Q00000X
Family Medicine Physician
ME116951
FL
Other
Enumeration date
06/20/2013
Last updated
08/18/2013
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