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Individual

DR. JAMES G CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
315 ISLE OF CAPRI DR, FORT LAUDERDALE, FL 33301-2409
(954) 319-0225
Mailing address
315 ISLE OF CAPRI DR, FORT LAUDERDALE, FL 33301-2409
(954) 319-0225

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD2006-0077
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12232033
NM
Enumeration date
06/30/2005
Last updated
05/15/2015
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